Doctor Name: | LUCIANNE W WARREN |
NPI Number: | 1063502060 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 082-03-002 |
Business Practice Address: | 5268 Godwin Blvd Suffolk, VA - 234348135 |
Business Phone Number: | 7572557117 |
Business Fax Number: | 7572557139 |
Mailing Address: | 5268 Godwin Blvd, SUFFOLK |
State: | VA |
Postal Code: | 234348135 |
Phone Number: | 7572557117 |
Fax Number: | 7572557139 |
NPI Enumeration Date: | 10/13/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 082-03-002 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |