Individual
EBONY MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3317 WOODROW AVE, RICHMOND, VA 23222-2720
(646) 963-1103
Mailing address
3317 WOODROW AVE, RICHMOND, VA 23222-2720
(646) 963-1103
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904018396
VA
Other
Enumeration date
05/09/2025
Last updated
05/09/2025
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