| Emerald Leaf Counseling Llc | |
|
5275 Lee Hwy Ste 104 Arlington VA 22207-1619 | |
| (703) 829-6350 | |
| Not Available |
| Full Name | Emerald Leaf Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 5275 Lee Hwy Ste 104, Arlington, Virginia |
| Authorized Official Name and Position | Miki Goerdt (OWNER) |
| Authorized Official Contact | 7038296350 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emerald Leaf Counseling Llc 2916 Lawrence Dr Falls Church VA 22042-1405 Ph: (703) 829-6350 | Emerald Leaf Counseling Llc 5275 Lee Hwy Ste 104 Arlington VA 22207-1619 Ph: (703) 829-6350 |
| NPI Number | 1518528959 |
|---|---|
| Provider Enumeration Date | 06/26/2019 |
| Last Update Date | 09/19/2019 |
| Medicare PECOS PAC ID | 8729317136 |
|---|---|
| Medicare Enrollment ID | O20190911000043 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518528959 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Miki Goerdt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558784520 PECOS PAC ID: 8123242781 Enrollment ID: I20140623000132 |
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