Provider Demographics
NPI:1083083422
Name:VOTH, EVA L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:EVA
Middle Name:L
Last Name:VOTH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1951 EVELYN BYRD AVE
Mailing Address - Street 2:STE. B
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3483
Mailing Address - Country:US
Mailing Address - Phone:540-437-0403
Mailing Address - Fax:540-437-0421
Practice Address - Street 1:1951 EVELYN BYRD AVE
Practice Address - Street 2:STE B
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3483
Practice Address - Country:US
Practice Address - Phone:540-437-0403
Practice Address - Fax:540-437-0421
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-16
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040083721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0904008372OtherLICENSED CLINICAL SOCIAL WORKER