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General NPI Number Information
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NPI Number | 1649115601
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Entity Type | Individual
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Provider Name | CARY-GRACE JAMES LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/23/2026
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Last Update Date | 04/23/2026
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Provider Practice Location Address
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Address Line | 2545 SANFORD AVE SW
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City | ROANOKE
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State | VA
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Zip | 24014-1123
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Country | US
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Telephone | 540-358-0765
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Fax |
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Provider Business Mailing Address
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Address Line | 607 HIGHLAND AVE SE
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City | ROANOKE
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State | VA
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Zip | 24013-2335
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Country | US
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Telephone | 540-904-9880
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Fax |
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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 | 0904020256
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License Number State | VA
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