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NPI Code Detail

MEDICARE: JENNIFER L. MCCAULEY LCSW

MEDICARE: JENNIFER L. MCCAULEY LCSW
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 Worker0904006484VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1294810OTHERVAANTHEM
2O802966MOTHERVAOPTIMA

General Provider Information

NPI Number : 1649312760
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER L. MCCAULEY LCSW
Provider Business Mailing Address
First Line : 4801 COX RD STE 205
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23060-6803
Country : US
Telephone Number : 804-796-0790
Fax Number : 804-796-0799
Provider Business Practice Location Address
First Line : 4801 COX RD STE 205
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23060-6803
Country : US
Telephone Number : 804-796-0790
Fax Number : 804-796-0799
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2007
Last Update Date : 02/11/2025

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