Provider Demographics
NPI:1992824031
Name:HALIFAX COUNTY DEPARTMENT OF SOCIAL SERVICES
Entity Type:Organization
Organization Name:HALIFAX COUNTY DEPARTMENT OF SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORK SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRISH
Authorized Official - Middle Name:
Authorized Official - Last Name:BARGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-476-6594
Mailing Address - Street 1:1030 COWFORD ROAD
Mailing Address - Street 2:MARY BETHUNE OFFICE COMPLEX
Mailing Address - City:HALIFAX
Mailing Address - State:VA
Mailing Address - Zip Code:24558
Mailing Address - Country:US
Mailing Address - Phone:434-476-6594
Mailing Address - Fax:434-476-5258
Practice Address - Street 1:1030 COWFORD ROAD
Practice Address - Street 2:MARY BETHUNE OFFICE COMPLEX
Practice Address - City:HALIFAX
Practice Address - State:VA
Practice Address - Zip Code:24558
Practice Address - Country:US
Practice Address - Phone:434-476-6594
Practice Address - Fax:434-476-5258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA8740968Medicaid