Melissa Leigh Raby, MA, MSW, LCSW, CSOTP

Individual provider Active NPI Clinical Social Worker · MC Kenney, VA

NPI 1619220100 · NPPES record last updated Jan 18, 2013

Key facts

NPI
1619220100
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
0904007084 (VA)
Practice address
9736 Lew Jones Rd
MC Kenney, VA 23872-2936
Phone
(804) 478-5006
NPI assigned
Oct 21, 2012
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Three Rivers Treatment Center LLC Past
since Apr 1, 2016
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904007084 VA Yes

Addresses

Primary practice location

9736 Lew Jones Rd
MC Kenney, VA 23872-2936

Mailing address

P.O. Box 27
MC Kenney, VA 23872
Phone (804) 478-5006

Other providers in MC Kenney, VA

All providers in MC Kenney, VA · Clinical Social Worker in Virginia

Sources for this page

Verify at the official NPI Registry.