Provider Demographics
NPI:1184340838
Name:FEUDO, ALISON (LMSW)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:FEUDO
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 1:2729 GALLOWS RD APT 207
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-7159
Mailing Address - Country:US
Mailing Address - Phone:413-658-5284
Mailing Address - Fax:
Practice Address - Street 1:200 LITTLE FALLS ST STE 306
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4302
Practice Address - Country:US
Practice Address - Phone:703-231-7991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09030035041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty