Provider Demographics
NPI:1093889198
Name:WOODWARD, ALICIA B (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:B
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:RR 3 BOX 282
Mailing Address - Street 2:3234 HUNDLEY BRANCH ROAD
Mailing Address - City:SCOTTSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24590-9265
Mailing Address - Country:US
Mailing Address - Phone:434-286-8808
Mailing Address - Fax:434-286-3165
Practice Address - Street 1:1 MORTON DR
Practice Address - Street 2:SUITE 502
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-6806
Practice Address - Country:US
Practice Address - Phone:434-293-5923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040056031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA103508OtherANTHEM BCBS