Provider Demographics
NPI:1811563844
Name:CHAI, EUNICE (LCSW)
Entity Type:Individual
Prefix:
First Name:EUNICE
Middle Name:
Last Name:CHAI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4512 FAIR VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-3829
Mailing Address - Country:US
Mailing Address - Phone:703-481-4137
Mailing Address - Fax:
Practice Address - Street 1:1850 CAMERON GLEN DR STE 600
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3343
Practice Address - Country:US
Practice Address - Phone:703-481-4137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-01
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040126871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical