Provider Demographics
NPI:1417195090
Name:WOODSON, ANN YEATTS (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:YEATTS
Last Name:WOODSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:ANN
Other - Middle Name:YEATTS
Other - Last Name:BRYANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:245 HAIRSTON ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-4137
Mailing Address - Country:US
Mailing Address - Phone:434-793-4931
Mailing Address - Fax:434-799-3100
Practice Address - Street 1:245 HAIRSTON ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-4137
Practice Address - Country:US
Practice Address - Phone:434-793-4931
Practice Address - Fax:434-799-3100
Is Sole Proprietor?:No
Enumeration Date:2009-02-04
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040020601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1538120670Medicaid