1164449781 NPI number — MS. VICTORIA S MCCLAVE LCSW

Table of content: MS. VICTORIA S MCCLAVE LCSW (NPI 1164449781)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164449781 NPI number — MS. VICTORIA S MCCLAVE LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCCLAVE
Provider First Name:
VICTORIA
Provider Middle Name:
S
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164449781
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
54 E LEE STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WARRENTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20186
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-347-0613
Provider Business Mailing Address Fax Number:
540-347-0768

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
54 E LEE STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WARRENTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20186
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-347-0613
Provider Business Practice Location Address Fax Number:
540-347-0768
Provider Enumeration Date:
07/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  0904002783 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 283282 . This is a "AMERIGROUP" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 7374054 . This is a "AETNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 214493 . This is a "MHN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 127404 . This is a "VALVE OPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 229973 . This is a "MAMSI OPTIMUM CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0726007 . This is a "CAPITAL CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 200567 . This is a "ANTHEM BCBS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com