Provider Demographics
NPI:1891183703
Name:EYNAN, MIRI (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:MIRI
Middle Name:
Last Name:EYNAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5241 COBBLERS STONE CT
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-7542
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8100 THREE CHOPT RD
Practice Address - Street 2:SUITE 133
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4833
Practice Address - Country:US
Practice Address - Phone:804-356-6992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040085521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical