Provider Demographics
NPI:1801365283
Name:FUNES, VIRGINIA (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:
Last Name:FUNES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11504 IVY BUSH CT
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-2261
Mailing Address - Country:US
Mailing Address - Phone:802-595-1551
Mailing Address - Fax:
Practice Address - Street 1:15480 ANNAPOLIS RD STE 202-148
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-1852
Practice Address - Country:US
Practice Address - Phone:301-685-5922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor