Individual
CHARLES R RICHEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
500 GLENDALE RD, GALAX, VA 24333-2208
(276) 236-1699
(276) 236-1715
Mailing address
200 HOSPITAL DR, GALAX, VA 24333-2227
(276) 236-1699
(276) 236-1715
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904002918
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004945298
—
VA
01
—
178387
ANTHEM BLUE CROSS
VA
01
—
521622
VALUE OPTIONS
VI
01
—
800011428
MEDICARE RAILROAD
VI
Enumeration date
08/17/2006
Last updated
08/24/2009
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