Provider Demographics
NPI:1013907302
Name:LAWDER, CATHERINE MACMILLAN (LCSW)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MACMILLAN
Last Name:LAWDER
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:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22924-0400
Mailing Address - Country:US
Mailing Address - Phone:434-282-4998
Mailing Address - Fax:434-979-1123
Practice Address - Street 1:914 E HIGH ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-4850
Practice Address - Country:US
Practice Address - Phone:434-282-4998
Practice Address - Fax:434-979-1123
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-27
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040023871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
800002735Medicare ID - Type Unspecified