Provider Demographics
NPI:1164449781
Name:MCCLAVE, VICTORIA S (LCSW)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:S
Last Name:MCCLAVE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 E LEE STREET
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186
Mailing Address - Country:US
Mailing Address - Phone:540-347-0613
Mailing Address - Fax:540-347-0768
Practice Address - Street 1:54 E LEE STREET
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186
Practice Address - Country:US
Practice Address - Phone:540-347-0613
Practice Address - Fax:540-347-0768
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040027831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA283282OtherAMERIGROUP
VA7374054OtherAETNA
214493OtherMHN
127404OtherVALVE OPTIONS
229973OtherMAMSI OPTIMUM CHOICE
0726007OtherCAPITAL CARE
VA200567OtherANTHEM BCBS