Provider Demographics
NPI:1689756223
Name:RANSOM, JANE WARNER (LCSW)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:WARNER
Last Name:RANSOM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:LOUISE
Other - Last Name:WARNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:420 THIRD STREET NE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902
Mailing Address - Country:US
Mailing Address - Phone:434-971-9287
Mailing Address - Fax:434-979-1762
Practice Address - Street 1:420 THIRD STREET NE
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902
Practice Address - Country:US
Practice Address - Phone:434-971-9287
Practice Address - Fax:434-979-1762
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040005131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA049098OtherBLUE CROSS BLUE SHIELD
VA086073OtherSENTARA
800000537Medicare ID - Type Unspecified