Provider Demographics
NPI:1093004715
Name:WOODWARD, VIRGINIA A (LCSW)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:A
Last Name:WOODWARD
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 1:143 EVERGREEN LN
Mailing Address - Street 2:
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-1412
Mailing Address - Country:US
Mailing Address - Phone:678-687-3306
Mailing Address - Fax:770-995-1959
Practice Address - Street 1:16 E WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-2279
Practice Address - Country:US
Practice Address - Phone:678-687-3306
Practice Address - Fax:770-995-1959
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0041421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical