Healthcare Provider Details

I. General information

NPI: 1407449085
Provider Name (Legal Business Name): ALEXIS ANN MCGRATH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2021
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 BYRD AVE
RICHMOND VA
23230-3033
US

IV. Provider business mailing address

2918 GARLAND AVE
RICHMOND VA
23222-3605
US

V. Phone/Fax

Practice location:
  • Phone: 804-592-6311
  • Fax:
Mailing address:
  • Phone: 804-956-9602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904011811
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: