Provider Demographics
NPI:1083369227
Name:GASPARINI, JEFFREY PATRICK (LCSW)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:PATRICK
Last Name:GASPARINI
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1603 SEDBERRY LN APT 204
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-7028
Mailing Address - Country:US
Mailing Address - Phone:804-338-0805
Mailing Address - Fax:
Practice Address - Street 1:5001 E PATRICK HENRY HWY
Practice Address - Street 2:
Practice Address - City:BURKEVILLE
Practice Address - State:VA
Practice Address - Zip Code:23922-3460
Practice Address - Country:US
Practice Address - Phone:804-766-3437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040135651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical