Individual
BRENDA INGRAM DANDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4825 S LABURNUM AVE, RICHMOND, VA 23231-2713
(804) 222-2607
(804) 236-9118
Mailing address
10299 WOODMAN RD, GLEN ALLEN, VA 23060-4419
(804) 727-8500
(804) 727-8580
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904002775
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085717
SENTARA
VA
01
—
110295
ANTHEM
VA
01
—
2169321
MAMSI
VA
01
—
256538
ANTHEM
VA
01
—
263146-000
MAGELLAN
VA
01
—
4945131
VIRGINIA PREMIER
VA
Enumeration date
02/19/2007
Last updated
01/25/2011
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