| Janice B. Hairston, Lcsw, Llc | |
|
400 Turner Rd Ste 5 Richmond VA 23225-6420 | |
| (804) 233-3300 | |
| (804) 275-0480 |
| Full Name | Janice B. Hairston, Lcsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 400 Turner Rd, Richmond, Virginia |
| Authorized Official Name and Position | Janice Bernadette Hairston (OWNER/PROVIDER) |
| Authorized Official Contact | 8042333300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Janice B. Hairston, Lcsw, Llc 5819 S Melbeck Rd Richmond VA 23234-5279 Ph: (804) 233-3300 | Janice B. Hairston, Lcsw, Llc 400 Turner Rd Ste 5 Richmond VA 23225-6420 Ph: (804) 233-3300 |
| NPI Number | 1790926020 |
|---|---|
| Provider Enumeration Date | 03/17/2009 |
| Last Update Date | 03/17/2009 |
| Medicare PECOS PAC ID | 4688837198 |
|---|---|
| Medicare Enrollment ID | O20120521000365 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790926020 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0904006223 (Virginia) | Primary |
| Provider Name | Janice B Hairston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538102967 PECOS PAC ID: 4789696311 Enrollment ID: I20060626000107 |
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