Provider Demographics
NPI:1609977370
Name:MCCROSKY, JUDITH BASS (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:BASS
Last Name:MCCROSKY
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 1:30 HOUSER DR
Mailing Address - Street 2:
Mailing Address - City:LOVETTSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20180-8632
Mailing Address - Country:US
Mailing Address - Phone:703-474-2722
Mailing Address - Fax:540-822-4597
Practice Address - Street 1:30 HOUSER DR
Practice Address - Street 2:
Practice Address - City:LOVETTSVILLE
Practice Address - State:VA
Practice Address - Zip Code:20180-8632
Practice Address - Country:US
Practice Address - Phone:703-474-2722
Practice Address - Fax:540-822-4597
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040030611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA220427OtherANTHEM BCBS