| Irene Ilachinski, Lcsw | |
|
10400 Eaton Place Ste 200 Fairfax VA 22030 | |
| (703) 591-5912 | |
| (703) 591-7210 |
| Full Name | Irene Ilachinski, Lcsw |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 10400 Eaton Place, Fairfax, Virginia |
| Authorized Official Name and Position | Irene Carol Ilachinski (OWNER/LICENSED CLINICAL SOCIAL WORK) |
| Authorized Official Contact | 7035915912 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Irene Ilachinski, Lcsw 10400 Eaton Place Ste 200 Fairfax VA 22030 Ph: (703) 591-5912 | Irene Ilachinski, Lcsw 10400 Eaton Place Ste 200 Fairfax VA 22030 Ph: (703) 591-5912 |
| NPI Number | 1346589587 |
|---|---|
| Provider Enumeration Date | 02/07/2013 |
| Last Update Date | 01/24/2020 |
| Certification Date | 01/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346589587 | NPI | - | NPPES |
| 01013047083 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0904006259 (Virginia) | Primary |
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