Provider Demographics
NPI:1083930424
Name:GRUBBS, MARCIA D (LPC)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:D
Last Name:GRUBBS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:481 MCLAWS CIR STE 1
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-5641
Mailing Address - Country:US
Mailing Address - Phone:706-654-6525
Mailing Address - Fax:
Practice Address - Street 1:481 MCLAWS CIR STE 1
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185
Practice Address - Country:US
Practice Address - Phone:706-654-6525
Practice Address - Fax:757-257-0475
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004767101Y00000X
GALPC005491101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor