Provider Demographics
NPI:1801393939
Name:THATCHER, JANE KENNEMER (MSW)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:KENNEMER
Last Name:THATCHER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7604 HERALD ST
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-5432
Mailing Address - Country:US
Mailing Address - Phone:703-658-5600
Mailing Address - Fax:703-658-5697
Practice Address - Street 1:7604 HERALD ST
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-5432
Practice Address - Country:US
Practice Address - Phone:703-658-5600
Practice Address - Fax:703-658-5697
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool