Provider Demographics
NPI:1124039821
Name:PRICE, DOROTHY S (LCSW)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:S
Last Name:PRICE
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 1:3715 HOSKINS DR
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-7256
Mailing Address - Country:US
Mailing Address - Phone:804-755-1183
Mailing Address - Fax:
Practice Address - Street 1:5821 STAPLES MILL RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228-5427
Practice Address - Country:US
Practice Address - Phone:804-264-0966
Practice Address - Fax:804-264-1029
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040015181041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA305441OtherANTHEM
VA022726OtherVALUE OPTIONS
VA305441OtherANTHEM