Doctor Name: | JEAN TODD |
NPI Number: | 1033470257 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 0904007840 |
Business Practice Address: | 8249 Crown Colony Pkwy Suite 200 Mechanicsville, VA - 231164057 |
Business Phone Number: | 8047891224 |
Business Fax Number: | 8047895964 |
Mailing Address: | 8249 Crown Colony Pkwy, Suite 200 MECHANICSVILLE |
State: | VA |
Postal Code: | 231164057 |
Phone Number: | 8047891224 |
Fax Number: | 8047895964 |
NPI Enumeration Date: | 06/05/2012 |
NPI Last Update Date: | 06/05/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 0904007840 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |