Provider Demographics
NPI:1356711642
Name:EHRMANTRAUT, RACHEL GAYLE (LCSW)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:GAYLE
Last Name:EHRMANTRAUT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:GAYLE
Other - Last Name:BOBOLIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15941 DONALD CURTIS DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-4256
Mailing Address - Country:US
Mailing Address - Phone:703-792-4900
Mailing Address - Fax:703-792-5699
Practice Address - Street 1:15941 DONALD CURTIS DR
Practice Address - Street 2:SUITE 200
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-4256
Practice Address - Country:US
Practice Address - Phone:703-792-4900
Practice Address - Fax:703-792-5699
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040089821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical