Individual
MR. EDWARD JOHN WHITACRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
11825 ROCK LANDING DR, THE JAMES BUILDING, NEWPORT NEWS, VA 23606-4236
(757) 873-1736
(757) 873-1028
Mailing address
4657 MASSENA DR, WILLIAMSBURG, VA 23188-1261
(757) 566-4824
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904002390
VA
Other
Enumeration date
08/04/2006
Last updated
07/08/2007
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