Organization
GLASS AND HENRY PC
Active
Other names
T A Larkspur Psychotheraphy Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ANN BAILEY HENRY LCSW (OWNER)
(757) 497-4965
Entity
Organization
Contact information
Practice address
505 S INDEPENDENCE BLVD, SUITE 207, VIRGINIA BEACH, VA 23452-1150
(757) 497-4965
(757) 497-4197
Mailing address
505 S INDEPENDENCE BLVD, SUITE 207, VIRGINIA BEACH, VA 23452-1150
(757) 497-4965
(757) 497-4197
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904003282
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
344120
TRICARE
—
01
—
A000899
VALUE OPTIONS
—
Enumeration date
02/08/2007
Last updated
01/25/2008
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