Provider Demographics
NPI:1497719736
Name:CROLIUS, VIRGINIA P (LPC)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:P
Last Name:CROLIUS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1500
Mailing Address - Street 2:243 WOODROW WILSON LANE
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-1500
Mailing Address - Country:US
Mailing Address - Phone:540-332-7101
Mailing Address - Fax:
Practice Address - Street 1:243 WOODROW WILSON LANE
Practice Address - Street 2:
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-1500
Practice Address - Country:US
Practice Address - Phone:540-332-7101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA070100914101YP2500X
VA0717000180106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005411947Medicaid