Individual
JEFFREY L LANDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.C.S.W., D.C.S.W.
Contact information
Practice address
59 E WEAVER AVE, HARRISONBURG, VA 22801-3047
(540) 434-6354
Mailing address
59 E WEAVER AVE, HARRISONBURG, VA 22801-3047
(540) 434-6354
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904001685
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891871711
—
VA
01
—
277940
ANTHEM PROVIDER NUMBER
VA
01
—
800013528
RAILROAD MEDICARE NUMBER
VA
01
—
DD4151
RAILROAD MEDICARE GROUP NUMBER
VA
Enumeration date
10/31/2006
Last updated
02/13/2016
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