Provider Demographics
NPI:1669990677
Name:VARKIANI, ELISABETH
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:
Last Name:VARKIANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 HERITAGE WAY NE SUITE 302
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20177-7400
Mailing Address - Country:US
Mailing Address - Phone:703-771-5100
Mailing Address - Fax:703-771-0170
Practice Address - Street 1:8200 GREENSBORO DR STE 900
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-4931
Practice Address - Country:US
Practice Address - Phone:703-621-1400
Practice Address - Fax:703-771-0170
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810006316103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical