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General NPI Number Information
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NPI Number | 1477831204
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Entity Type | Organization
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Legal Business Name | KRIS SANTAMARIA, LCSW
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Dates
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Enumeration Date | 07/27/2011
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Last Update Date | 12/21/2015
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Provider Practice Location Address
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Address Line | 315 WINDING RIVER LN SUITE 201
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22911-3568
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Country | US
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Telephone | 434-249-1304
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Fax | 434-961-2556
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Provider Business Mailing Address
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Address Line | 1120 SNOWDEN DR
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-1297
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Country | US
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Telephone | 434-249-1304
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Fax | 434-961-2556
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | KRIS SANTAMARIA
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Credential | LCSW
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Telephone | 434-249-1304
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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 | 0904004448
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License Number State | VA
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