Provider Demographics
NPI:1295833663
Name:CRITZER, PENELOPE ANN (MSW,LCSW)
Entity Type:Individual
Prefix:MRS
First Name:PENELOPE
Middle Name:ANN
Last Name:CRITZER
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 LAMBERT ST
Mailing Address - Street 2:SUITE 222
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-2446
Mailing Address - Country:US
Mailing Address - Phone:540-886-3956
Mailing Address - Fax:540-886-3975
Practice Address - Street 1:40 LAMBERT ST
Practice Address - Street 2:SUITE 222
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-2446
Practice Address - Country:US
Practice Address - Phone:540-886-3956
Practice Address - Fax:540-886-3975
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040027371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA061806OtherANTHEM
VA085191OtherSENTARA/SOUTHERN HEALTH