Provider Demographics
NPI:1932332558
Name:TEHAN, EILEEN THERESE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:THERESE
Last Name:TEHAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9202 CENTER OAK CT
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-2744
Mailing Address - Country:US
Mailing Address - Phone:804-207-6737
Mailing Address - Fax:
Practice Address - Street 1:17336 PICKWICK DR STE 101
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-6180
Practice Address - Country:US
Practice Address - Phone:804-207-6737
Practice Address - Fax:703-665-7686
Is Sole Proprietor?:No
Enumeration Date:2009-08-30
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD113891041C0700X
MELC179011041C0700X
VA09040118871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical