Healthcare Provider Details

I. General information

NPI: 1528977840
Provider Name (Legal Business Name): ANNA HARRIS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 BOARS HEAD LN STE C6
CHARLOTTESVILLE VA
22903-4604
US

IV. Provider business mailing address

904 GLENCOE AVE
WAYNESBORO VA
22980-3025
US

V. Phone/Fax

Practice location:
  • Phone: 434-566-0113
  • Fax:
Mailing address:
  • Phone: 434-327-3164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904020974
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: