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General NPI Number Information
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NPI Number | 1194908079
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Entity Type | Individual
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Provider Name | KATRINA H MANSINON LCSW MSW
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Gender | Female
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Dates
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Enumeration Date | 12/13/2007
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Last Update Date | 11/30/2011
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Provider Practice Location Address
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Address Line | 1901 HUGUENOT RD SUITE 201
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City | RICHMOND
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State | VA
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Zip | 23235
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Country | US
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Telephone | 804-254-2297
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Fax | 804-378-2078
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Provider Business Mailing Address
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Address Line | PO BOX 35395 SUITE 201
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City | RICHMOND
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State | VA
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Zip | 23235-4311
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Country | US
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Telephone | 804-378-3364
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Fax | 804-378-2078
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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 | 0904006716
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License Number State | VA
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