Provider Demographics
NPI:1881469757
Name:GARRETT, VIRGINIA LYNN (MA PPC)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:LYNN
Last Name:GARRETT
Suffix:
Gender:
Credentials:MA PPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-2503
Mailing Address - Country:US
Mailing Address - Phone:308-631-0761
Mailing Address - Fax:
Practice Address - Street 1:416 VALLEY VIEW DR STE 300
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-1420
Practice Address - Country:US
Practice Address - Phone:308-631-0761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-20
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-2405101YM0800X
WYPPC-1387101YM0800X
NE14182101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health