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General NPI Number Information
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NPI Number | 1538705413
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Entity Type | Individual
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Provider Name | JEFFREY LETCHFORD LCSW
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Gender | Male
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Dates
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Enumeration Date | 11/26/2019
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Last Update Date | 11/10/2024
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Provider Practice Location Address
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Address Line | 4419 PHEASANT RIDGE RD # SUIE200
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City | ROANOKE
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State | VA
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Zip | 24014-5282
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Country | US
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Telephone | 540-355-6957
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Fax | 540-556-3320
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Provider Business Mailing Address
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Address Line | 4419 PHEASANT RIDGE RD # SUIE200
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City | ROANOKE
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State | VA
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Zip | 24014-5282
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Country | US
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Telephone | 540-355-6957
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Fax | 540-556-3320
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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 | 0904011384
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License Number State | VA
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