Healthcare Provider Details

I. General information

NPI: 1740161942
Provider Name (Legal Business Name): TREONNA EUBANKS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2025
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3908 NINE MILE RD
RICHMOND VA
23223-4913
US

IV. Provider business mailing address

10299 WOODMAN RD 3908 NINE MILE RD
GLEN ALLEN VA
23060-4419
US

V. Phone/Fax

Practice location:
  • Phone: 804-727-8100
  • Fax:
Mailing address:
  • Phone: 804-727-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904019129
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: