Goerdt, Miki Nishida

Goerdt, Miki Nishida is an sole proprietor health care provider with primary practice located at 2916 Lawrence Dr , Falls Church VA 22042-1405. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Goerdt, Miki Nishida can be contacted via phone (703) 829-6350.

Contact Information

Primary practice address
2916 Lawrence Dr Falls Church VA 22042-1405
Phone: (703) 829-6350
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 0904007089 Virginia
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 0904007089 Virginia

Profile Details

NPI number 1558784520
LBN Legal business name Goerdt, Miki Nishida
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 28th, 2014
Last updated Aug 29th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558784520 NPPES
Virginia Other 0904007089 VA SOCIAL WORK LICENES

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