Provider Demographics
NPI:1396010054
Name:BLAIR, ANNE HWANG (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:HWANG
Last Name:BLAIR
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 1:911 E JEFFERSON ST
Mailing Address - Street 2:P.O. BOX 277
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-5355
Mailing Address - Country:US
Mailing Address - Phone:540-582-3980
Mailing Address - Fax:
Practice Address - Street 1:7424 BROCK RD
Practice Address - Street 2:
Practice Address - City:SPOTSYLVANIA
Practice Address - State:VA
Practice Address - Zip Code:22553-2002
Practice Address - Country:US
Practice Address - Phone:540-582-3980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-14
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040070191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical