Provider Demographics
NPI:1669888210
Name:CAVE, LAUREN MCRAE
Entity type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:MCRAE
Last Name:CAVE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 POPLAR DR
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23805-9367
Mailing Address - Country:US
Mailing Address - Phone:804-733-6874
Mailing Address - Fax:804-862-6329
Practice Address - Street 1:350 POPLAR DR
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-9367
Practice Address - Country:US
Practice Address - Phone:804-733-6874
Practice Address - Fax:804-862-6329
Is Sole Proprietor?:No
Enumeration Date:2014-07-03
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1124051701Medicaid
VA004945182Medicaid