Provider Demographics
NPI:1457624967
Name:GARRABRANT, ELLEN (LCSW)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:GARRABRANT
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 1:8545 PATTERSON AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23229-6455
Mailing Address - Country:US
Mailing Address - Phone:804-774-6705
Mailing Address - Fax:804-556-6877
Practice Address - Street 1:8545 PATTERSON AVE STE 102
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23229-6455
Practice Address - Country:US
Practice Address - Phone:804-774-6705
Practice Address - Fax:804-556-6877
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-14
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040077731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical