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NPI Code Detail

MEDICARE: LANCIE MAZZA L.C.S.W.

MEDICARE: LANCIE MAZZA L.C.S.W.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker0904004664VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1190569OTHERVATRICARE
2317878OTHERVAHEALTHKEEPERS
32055547OTHERVACIGNA
4O83684OTHERVASOUTHERN HEALTH
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6317878OTHERVAANTHEM
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8416429OTHERVAVALUE OPTIONS
97814356OTHERVAAETNA

General Provider Information

NPI Number : 1033172010
Entity Type Code : Individual
Provider Name (Legal Business Name) : LANCIE MAZZA L.C.S.W.
Provider Business Mailing Address
First Line : 9228 GEORGE WASHINGTON MEMORIAL HWY
Second Line :
City : GLOUCESTER
State : VA
Zip : 23061-4162
Country : US
Telephone Number : 804-693-5068
Fax Number : 804-693-7407
Provider Business Practice Location Address
First Line : 414 MAIN ST
Second Line :
City : WARSAW
State : VA
Zip : 22572-4291
Country : US
Telephone Number : 804-333-3671
Fax Number : 804-333-3657
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2006
Last Update Date : 07/09/2007

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Practice Location Address:
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1598727729 — SUSAN O.K. CAMPAGNOLA L.C.S.W.
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1558323402 — WANDA J DUNGAN L.P.C.
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1528021508 — JUDITH H NOTARIANNI L.C.S.W.
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1124410832 — BEATE ROSE L.P.C.
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Directions to “ LANCIE MAZZA L.C.S.W.” Practice Location

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