Provider Demographics
NPI:1902839814
Name:KREBS, IRENE B (LCSW)
Entity type:Individual
Prefix:MS
First Name:IRENE
Middle Name:B
Last Name:KREBS
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 1:307 MAPLE AVE W
Mailing Address - Street 2:STE A2
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4307
Mailing Address - Country:US
Mailing Address - Phone:703-255-0030
Mailing Address - Fax:
Practice Address - Street 1:307 MAPLE AVE W
Practice Address - Street 2:STE A2
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4307
Practice Address - Country:US
Practice Address - Phone:703-255-0030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040004171041C0700X
VA0717000731106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
022052OtherVALUE OPTIONS
VA040428OtherANTHEM BCBS
VA040428OtherANTHEM BCBS