Healthcare Provider Details

I. General information

NPI: 1124076740
Provider Name (Legal Business Name): VIRGINIA PARR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 03/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

719 N 25TH ST
RICHMOND VA
23223-6539
US

IV. Provider business mailing address

719 N 25TH ST
RICHMOND VA
23223-6539
US

V. Phone/Fax

Practice location:
  • Phone: 804-780-0840
  • Fax: 804-253-1979
Mailing address:
  • Phone: 804-780-0840
  • Fax: 804-253-1979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number0904004646
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: