Individual
MRS. CHARESE LAKISA JOSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
500 WASHINGTON ST STE A, PORTSMOUTH, VA 23704-3508
(757) 613-8801
Mailing address
500 WASHINGTON ST STE A, PORTSMOUTH, VA 23704-3508
(757) 613-8801
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
0904006053
VA
1041C0700X
Clinical Social Worker
Primary
0904006053
VA
Other
Enumeration date
09/23/2013
Last updated
07/08/2019
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