Provider Demographics
NPI:1952384786
Name:HUNTER, JOHANNA MACGILLIVRAY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOHANNA
Middle Name:MACGILLIVRAY
Last Name:HUNTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JOHANNA
Other - Middle Name:MARIE
Other - Last Name:MACGILLIVRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:5802 KATELYN MARY PL
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-5431
Mailing Address - Country:US
Mailing Address - Phone:703-805-0110
Mailing Address - Fax:703-805-0967
Practice Address - Street 1:9501 FARRELL RD
Practice Address - Street 2:
Practice Address - City:FORT BELVOIR
Practice Address - State:VA
Practice Address - Zip Code:22060-5901
Practice Address - Country:US
Practice Address - Phone:703-805-0110
Practice Address - Fax:703-805-0967
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040019921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical