Provider Demographics
NPI:1750430997
Name:TATE, ANN BARRY (LCSW)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:BARRY
Last Name:TATE
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 1:198 BEAN HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:FLINT HILL
Mailing Address - State:VA
Mailing Address - Zip Code:22627-1804
Mailing Address - Country:US
Mailing Address - Phone:540-675-3700
Mailing Address - Fax:
Practice Address - Street 1:165 E DAVIS ST
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3011
Practice Address - Country:US
Practice Address - Phone:540-829-9033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904002358101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA89-0088-4Medicaid