Provider Demographics
NPI:1780939173
Name:CLANCEY, JAMIE MEREDITH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:MEREDITH
Last Name:CLANCEY
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 1:2488 POST OAK DR
Mailing Address - Street 2:
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-4198
Mailing Address - Country:US
Mailing Address - Phone:540-718-3041
Mailing Address - Fax:
Practice Address - Street 1:102 N MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3053
Practice Address - Country:US
Practice Address - Phone:540-718-3041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-20
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040075481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical