Individual
LATOYA CHEATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
13649 OFFICE PL STE 102, WOODBRIDGE, VA 22192-4215
(703) 670-5738
Mailing address
13649 OFFICE PL STE 102, WOODBRIDGE, VA 22192-4215
(703) 670-5738
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904008600
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
256400
ANTHEM BCBS
VA
Enumeration date
05/20/2014
Last updated
01/20/2020
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