Provider Demographics
NPI:1750515953
Name:BARBOUR, MARJORIE PACE (LCSW)
Entity type:Individual
Prefix:
First Name:MARJORIE
Middle Name:PACE
Last Name:BARBOUR
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 1:205 N BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-4006
Mailing Address - Country:US
Mailing Address - Phone:804-355-8735
Mailing Address - Fax:804-353-1173
Practice Address - Street 1:205 N BOULEVARD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-4006
Practice Address - Country:US
Practice Address - Phone:804-355-8735
Practice Address - Fax:804-353-1173
Is Sole Proprietor?:No
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040070821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical