Provider Demographics
NPI:1437311859
Name:RALSTON, DONNA ASHTON (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:DONNA
Middle Name:ASHTON
Last Name:RALSTON
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 1:100 PINEWOOD RD
Mailing Address - Street 2:222
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-3967
Mailing Address - Country:US
Mailing Address - Phone:757-377-4418
Mailing Address - Fax:
Practice Address - Street 1:100 PINEWOOD RD
Practice Address - Street 2:222
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-3967
Practice Address - Country:US
Practice Address - Phone:757-377-4418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040068371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAO804330MOtherOPTIMA
VASC0001045Medicare PIN