Provider Demographics
NPI:1770698300
Name:EDELMAN, DAVID ARMSTRONG (MSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ARMSTRONG
Last Name:EDELMAN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1816 OPALOCKA DR
Mailing Address - Street 2:
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-5445
Mailing Address - Country:US
Mailing Address - Phone:703-533-5634
Mailing Address - Fax:703-532-0597
Practice Address - Street 1:107 PARK PL
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4513
Practice Address - Country:US
Practice Address - Phone:703-533-5634
Practice Address - Fax:703-532-0597
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040032641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA037347001487M47Medicare ID - Type Unspecified