Provider Demographics
NPI:1134661259
Name:BLANKENSHIP-LOKER, ADRIENNE LEIGH (LCSW)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:LEIGH
Last Name:BLANKENSHIP-LOKER
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 1:5408 CHAMBERLAYNE RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-2407
Mailing Address - Country:US
Mailing Address - Phone:804-272-2000
Mailing Address - Fax:804-272-2030
Practice Address - Street 1:905 SOUTHLAKE BLVD STE C
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-3955
Practice Address - Country:US
Practice Address - Phone:804-419-0492
Practice Address - Fax:804-419-0500
Is Sole Proprietor?:No
Enumeration Date:2016-11-07
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040096131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical