Provider Demographics
NPI:1952154957
Name:MCCAIN, JEANNETTE ANDREA (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JEANNETTE
Middle Name:ANDREA
Last Name:MCCAIN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MRS
Other - First Name:JEANNIE
Other - Middle Name:DOYLE
Other - Last Name:MCCAIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:1019 AMBER MEADOWS PL
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-1295
Mailing Address - Country:US
Mailing Address - Phone:804-397-5774
Mailing Address - Fax:
Practice Address - Street 1:8310 MIDLOTHIAN TPKE
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-5163
Practice Address - Country:US
Practice Address - Phone:804-447-6382
Practice Address - Fax:804-447-6383
Is Sole Proprietor?:No
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040052961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical