Individual
BETTY ALEXANDRA KEDROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1709 COLLEY AVE, SUITE 312, NORFOLK, VA 23517-1675
(757) 640-0400
(757) 640-0497
Mailing address
1709 COLLEY AVE, SUITE 312, NORFOLK, VA 23517-1675
(757) 640-0400
(757) 640-0497
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904000234
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028883
VALUE OPTION
VA
01
—
049958
BLUE CROSS BLUE SHIELD
VA
01
—
080436
OPTIMA
VA
01
—
216188
UCH
VA
01
—
247697
COM PSYCH
—
01
—
324004
MANAGED HEALTH NETWORK
—
01
—
5264256
AETNA
VA
05
—
8908478
—
VA
01
—
A163599
VALUE OPTIONS
—
Enumeration date
07/27/2005
Last updated
07/08/2007
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