Provider Demographics
NPI:1023547528
Name:WURFEL, GINA ELYSIA (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:ELYSIA
Last Name:WURFEL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:E
Other - Last Name:SUSLICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1800 GLENSIDE DR.
Mailing Address - Street 2:SUITE 104
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226
Mailing Address - Country:US
Mailing Address - Phone:804-288-0399
Mailing Address - Fax:804-673-7067
Practice Address - Street 1:9020 STONY POINT PKWY STE 350
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-1945
Practice Address - Country:US
Practice Address - Phone:952-202-9755
Practice Address - Fax:844-541-1162
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0903002538104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker