MEDICARE: MRS. KATHRYN JEAN WEBB LCSW, CAS

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
1	1041C0700X	Clinical Social Worker	0904008604	VA

General Provider Information

NPI Number	:	1326449851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHRYN JEAN WEBB LCSW, CAS

Provider Business Mailing Address
First Line	:	7416 WASHINGTON ARCH DR
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23111-4732
Country	:	US
Telephone Number	:	804-944-0800
Fax Number	:	804-299-4727

Provider Business Practice Location Address
First Line	:	6501 MECHANICSVILLE TPKE STE G3
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23111-3698
Country	:	US
Telephone Number	:	804-417-6525
Fax Number	:	804-299-4727

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2014
Last Update Date	:	10/13/2021

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