Provider Demographics
NPI:1558421982
Name:WINTER, JOAN (LCSW,EDS)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:WINTER
Suffix:
Gender:F
Credentials:LCSW,EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 MONUMENT AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-1404
Mailing Address - Country:US
Mailing Address - Phone:804-355-6876
Mailing Address - Fax:804-355-2597
Practice Address - Street 1:2910 MONUMENT AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23221-1404
Practice Address - Country:US
Practice Address - Phone:804-355-6876
Practice Address - Fax:804-355-2597
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040003501041C0700X
VA0717000888106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist