Provider Demographics
NPI:1952442717
Name:CONSTANT, JEAN-ANDRE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JEAN-ANDRE
Middle Name:
Last Name:CONSTANT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:JEAN
Other - Middle Name:ANDRE
Other - Last Name:CONSTANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:12254 PURCELL RD
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20112-3213
Mailing Address - Country:US
Mailing Address - Phone:571-502-5159
Mailing Address - Fax:
Practice Address - Street 1:4379 RIDGEWOOD CENTER DR STE 102
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-8323
Practice Address - Country:US
Practice Address - Phone:703-680-7950
Practice Address - Fax:703-680-7953
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040099391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0904009939OtherVIRGINIA BOARD OF SOCIAL WORK