# ELAINE P. BOOMER PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285955021
- **Authorized official:** MS. ELAINE P BOOMER LCSW (PRESIDENT)
- **Authorized official phone:** (703) 255-2208

## Contact information

- **Practice address:** 501 CHURCH ST NE, SUITE 206, VIENNA, VA 22180-4734
- **Practice address phone:** (703) 255-2208
- **Practice address fax:** (703) 255-2482
- **Mailing address:** 501 CHURCH ST NE, SUITE 206, VIENNA, VA 22180-4734
- **Mailing address phone:** (703) 255-2208
- **Mailing address fax:** (703) 255-2482

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 0904003838 | VA | Yes |

## Other

- **Enumeration date:** 06/16/2010
- **Last updated:** 06/16/2010