Provider Demographics
NPI:1225164296
Name:MILKAVICH, JOAN R (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:R
Last Name:MILKAVICH
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 MCLAWS CIR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-6347
Mailing Address - Country:US
Mailing Address - Phone:757-564-4590
Mailing Address - Fax:757-229-8937
Practice Address - Street 1:352 MCLAWS CIR
Practice Address - Street 2:SUITE 3
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-6347
Practice Address - Country:US
Practice Address - Phone:757-564-4590
Practice Address - Fax:757-229-8937
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001546101YM0800X
VA0717000445106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist