Elizabeth Michelle Bostic, LCSW

Individual provider Active NPI Clinical Social Worker · Danville, VA

NPI 1013092345 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1013092345
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
0904002039 (VA)
Practice address
1611 Old Mayfield Rd
Danville, VA 24541-7511
Phone
(434) 799-3318
Fax
(434) 799-3318
NPI assigned
Oct 26, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0904002039VAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904002039 VA Yes

Addresses

Primary practice location

1611 Old Mayfield Rd
Danville, VA 24541-7511

Mailing address

1611 Old Mayfield Rd
Danville, VA 24541-7511
Phone (434) 799-3318

Other providers in Danville, VA

All providers in Danville, VA · Clinical Social Worker in Virginia

Sources for this page

Verify at the official NPI Registry.