Provider Demographics
NPI:1881733590
Name:GROVES, BARBARA IRENE (LCSW)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:IRENE
Last Name:GROVES
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 1:6091 ROCKFISH VALLEY HWY
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:VA
Mailing Address - Zip Code:22920-3029
Mailing Address - Country:US
Mailing Address - Phone:434-361-1984
Mailing Address - Fax:
Practice Address - Street 1:1108 EAST MARKET STREET
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901
Practice Address - Country:US
Practice Address - Phone:434-906-9448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040049541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA8938016Medicaid
VA003252C90Medicare ID - Type Unspecified