Provider Demographics
NPI:1821030172
Name:BATELAAN, SANDERIJN IRENE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SANDERIJN
Middle Name:IRENE
Last Name:BATELAAN
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 1:1520 CHATHAM COLONY CT
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-4203
Mailing Address - Country:US
Mailing Address - Phone:703-629-4531
Mailing Address - Fax:
Practice Address - Street 1:224A CORNWALL ST NW
Practice Address - Street 2:301
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-2701
Practice Address - Country:US
Practice Address - Phone:703-443-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904005774101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1821030172Medicaid
1821030172Medicare NSC