Provider Demographics
NPI:1528021508
Name:NOTARIANNI, JUDITH H (LCSW)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:H
Last Name:NOTARIANNI
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 1:9228 GEORGE WASHINGTON MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23061-4162
Mailing Address - Country:US
Mailing Address - Phone:804-693-5068
Mailing Address - Fax:804-693-7407
Practice Address - Street 1:414 MAIN ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:VA
Practice Address - Zip Code:22572-4291
Practice Address - Country:US
Practice Address - Phone:804-333-3671
Practice Address - Fax:804-333-3657
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040020561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA149113000OtherMAGELLAN
VA433821OtherHEALTHKEEPERS
VAO83746Medicaid
VA022986OtherVALUE OPTIONS
VAO83746OtherSOUTHERN HEALTH
VA132214OtherTRICARE
VA433821OtherANTHEM
VA2059533OtherCIGNA
VA004945115Medicaid
VA433821Medicaid
VA7591013OtherAETNA
VAO83746Medicaid
VA433821OtherANTHEM