Provider Demographics
NPI:1003674490
Name:LAFRATTA, JOANNA (LMSW)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:LAFRATTA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 SARATOGA DR
Mailing Address - Street 2:
Mailing Address - City:FORT GREGG ADAMS
Mailing Address - State:VA
Mailing Address - Zip Code:23801-1491
Mailing Address - Country:US
Mailing Address - Phone:254-290-5273
Mailing Address - Fax:
Practice Address - Street 1:601 SARATOGA DR
Practice Address - Street 2:
Practice Address - City:FORT GREGG ADAMS
Practice Address - State:VA
Practice Address - Zip Code:23801-1491
Practice Address - Country:US
Practice Address - Phone:254-290-5273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0903003787104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker