Individual
JANICE BERNADETTE HAIRSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
10106 KRAUSE RD STE 207, CHESTERFIELD, VA 23832-6503
(804) 233-3300
(804) 674-5361
Mailing address
10106 KRAUSE RD STE 207, CHESTERFIELD, VA 23832-6503
(804) 233-3300
(804) 674-5361
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904006223
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010246156
—
VA
01
—
189372
ANTHEM, BC/BS, HEALTHKEEP
VA
Enumeration date
06/14/2006
Last updated
10/01/2024
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