Provider Demographics
NPI:1801967021
Name:MCCABE, MINDA D (LCSW)
Entity type:Individual
Prefix:MS
First Name:MINDA
Middle Name:D
Last Name:MCCABE
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 1:4 W MONMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-4652
Mailing Address - Country:US
Mailing Address - Phone:540-665-1786
Mailing Address - Fax:540-722-4550
Practice Address - Street 1:4 W MONMOUTH ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-4652
Practice Address - Country:US
Practice Address - Phone:540-665-1786
Practice Address - Fax:540-722-4550
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040014431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
88787OtherCOMMUNITY HEALTH-SENTERA
VA8949565Medicaid
141861375OtherTRICARE-CHAMPUS
325536OtherALLIANCE-MAMSI
VA462444OtherANTHEM
141861375OtherTRICARE-CHAMPUS