Provider Demographics
NPI:1982825501
Name:KATCHIS, SOPHIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SOPHIA
Middle Name:
Last Name:KATCHIS
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 1:3911 TIMBER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-4542
Mailing Address - Country:US
Mailing Address - Phone:804-928-3571
Mailing Address - Fax:
Practice Address - Street 1:2217 PRINCESS ANNE ST
Practice Address - Street 2:SUITE 105
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3353
Practice Address - Country:US
Practice Address - Phone:804-928-3571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040031571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA263769OtherMDIPA
VA454303OtherBLUE CROSS