Provider Demographics
NPI:1023357266
Name:PROBST, JANE C (LCSW)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:C
Last Name:PROBST
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 1:19223 BELLE CLAIRE ROAD
Mailing Address - Street 2:
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701
Mailing Address - Country:US
Mailing Address - Phone:540-827-7395
Mailing Address - Fax:540-518-9102
Practice Address - Street 1:206 W EDMONDSON ST
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-2618
Practice Address - Country:US
Practice Address - Phone:540-827-7395
Practice Address - Fax:540-518-9102
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-07
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040081471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0904008147OtherLCSW