Provider Demographics
NPI:1508957820
Name:RAUSCH, JESSICA MARIE (MSW LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:MARIE
Last Name:RAUSCH
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:MARIE
Other - Last Name:STEFFEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:726 MADISON AVE
Mailing Address - Street 2:APT B
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903
Mailing Address - Country:US
Mailing Address - Phone:434-409-1272
Mailing Address - Fax:
Practice Address - Street 1:1450 SACHEM PLACE
Practice Address - Street 2:SUITE NUMBER 101
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901
Practice Address - Country:US
Practice Address - Phone:434-973-5640
Practice Address - Fax:434-973-0290
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904006157104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA184325OtherANTHEM BLUE CROSS BLUE SH