| Dr. James W. Eisenhower, Ph.d, Lcsw, Llc | |
|
281 Independence Blvd #305 Virginia Beach VA 23462-2986 | |
| (757) 373-6051 | |
| (757) 497-1327 |
| Full Name | Dr. James W. Eisenhower, Ph.d, Lcsw, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 281 Independence Blvd, Virginia Beach, Virginia |
| Authorized Official Name and Position | James W. Eisenhower (LCSW) |
| Authorized Official Contact | 7573736051 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. James W. Eisenhower, Ph.d, Lcsw, Llc 281 Independence Blvd #305 Virginia Beach VA 23462-2986 Ph: (757) 373-6051 | Dr. James W. Eisenhower, Ph.d, Lcsw, Llc 281 Independence Blvd #305 Virginia Beach VA 23462-2986 Ph: (757) 373-6051 |
| NPI Number | 1720293772 |
|---|---|
| Provider Enumeration Date | 05/12/2007 |
| Last Update Date | 08/03/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720293772 | NPI | - | NPPES |
| 1952407900 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0904000683 (Virginia) | Primary |
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