Provider Demographics
NPI:1194881631
Name:HYMAN, JANET LYNN (LCSW)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:LYNN
Last Name:HYMAN
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 1:12050 S LAKES DR
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-1220
Mailing Address - Country:US
Mailing Address - Phone:703-476-5974
Mailing Address - Fax:703-860-8824
Practice Address - Street 1:12050 S LAKES DR
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-1220
Practice Address - Country:US
Practice Address - Phone:703-476-5974
Practice Address - Fax:703-860-8824
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040016791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA586077924OtherTRICARE
VA224188OtherANTHEM BLUE CROSS
VA138242OtherVALUE OPTIONS
VA586077924OtherTRICARE