Provider Demographics
NPI:1487346805
Name:DOLL, ANDREW LAWRENCE (LCSW)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:LAWRENCE
Last Name:DOLL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5776 FIRST LANDING WAY
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-2644
Mailing Address - Country:US
Mailing Address - Phone:202-888-9271
Mailing Address - Fax:
Practice Address - Street 1:5776 FIRST LANDING WAY
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-2644
Practice Address - Country:US
Practice Address - Phone:202-888-9271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040121091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical