Provider Demographics
NPI:1821180951
Name:POPE, TERESA D (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:D
Last Name:POPE
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 1:2100 HUGUENOT SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-7201
Mailing Address - Country:US
Mailing Address - Phone:804-464-2751
Mailing Address - Fax:804-464-2751
Practice Address - Street 1:2100 HUGUENOT SPRINGS RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-7201
Practice Address - Country:US
Practice Address - Phone:804-464-2751
Practice Address - Fax:804-464-2751
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2008-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040022041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1821180951Medicaid