Edith Lynne Brokaw, LCSW, CSAC
Social Worker, Clinical in Ashburn, VA. Individual provider (NPI-1).
NPI number1639284326
StatusActive
Last updated in NPPESAug 8, 2012
Details
- NPI
- 1639284326
- Entity type
- Individual (NPI-1)
- Name
- Ms. Edith Lynne Brokaw
- Credential
- LCSW, CSAC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 20, 2006
- Last updated
- Aug 8, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 0904005800 | VA | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 0710102052 | VA |
Practice location
44081 Pipeline Plz#105
Ashburn, VA 20147-5891
Phone 703-403-6944
Mailing address
44104 Natalie TerSuite 102
Ashburn, VA 20147-7901
Phone 703-403-6944
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