Healthcare Provider Details

I. General information

NPI: 1144646571
Provider Name (Legal Business Name): GWEN V SPERLING LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2014
Last Update Date: 10/04/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7716 JAHNKE RD
NORTH CHESTERFIELD VA
23225-2121
US

IV. Provider business mailing address

7716 JAHNKE RD
NORTH CHESTERFIELD VA
23225-2121
US

V. Phone/Fax

Practice location:
  • Phone: 804-975-5333
  • Fax:
Mailing address:
  • Phone: 804-975-5333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4050
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904015858
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: