Provider Demographics
NPI:1942736061
Name:MUKUYE, HENRY (LCSW)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:
Last Name:MUKUYE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 W PILKINGTON ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-3943
Mailing Address - Country:US
Mailing Address - Phone:804-304-7482
Mailing Address - Fax:
Practice Address - Street 1:5540 FALMOUTH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-1800
Practice Address - Country:US
Practice Address - Phone:804-304-7482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040098551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical