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General NPI Number Information
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NPI Number | 1023415213
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Entity Type | Individual
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Provider Name | LEA ANNE VARBLE LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/03/2014
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Last Update Date | 12/03/2014
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Provider Practice Location Address
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Address Line | 815 E 5TH ST SUITE 101
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City | ALTON
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State | IL
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Zip | 62002-6471
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Country | US
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Telephone | 618-463-5278
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Fax | 618-474-6242
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Provider Business Mailing Address
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Address Line | 1 SAINT ANTHONYS WAY
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City | ALTON
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State | IL
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Zip | 62002-4568
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Country | US
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Telephone | 618-463-5730
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Fax | 618-465-1355
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.012400
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License Number State | IL
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