Provider Demographics
NPI:1366624108
Name:LYNCHBURG DEPT SOCIAL SVS
Entity Type:Organization
Organization Name:LYNCHBURG DEPT SOCIAL SVS
Other - Org Name:LOCAL GOVERMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF SOCIAL SVS
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-455-5803
Mailing Address - Street 1:PO BOX 6798
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24505
Mailing Address - Country:US
Mailing Address - Phone:434-455-5773
Mailing Address - Fax:434-847-1540
Practice Address - Street 1:99 9TH STREET
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24504
Practice Address - Country:US
Practice Address - Phone:434-455-5773
Practice Address - Fax:434-847-1540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty