Healthcare Provider Details

I. General information

NPI: 1285605972
Provider Name (Legal Business Name): LISA ANNETTE BARBER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MCDONALD ARMY COMMUNITY HOSPITAL USAMEDDAC, BLDG 515
FT. EUSTIS VA
23604
US

IV. Provider business mailing address

611 OLD DOMINION RD
YORKTOWN VA
23692-4738
US

V. Phone/Fax

Practice location:
  • Phone: 757-314-7910
  • Fax: 757-314-7576
Mailing address:
  • Phone: 757-898-0676
  • Fax: 757-314-7576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904003948
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: