Provider Demographics
NPI:1447494661
Name:ARCHARD, ALBERT LEONIDAS (LEE) (LCSW)
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:LEONIDAS (LEE)
Last Name:ARCHARD
Suffix:
Gender:M
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:PO BOX 2468
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23061-2468
Mailing Address - Country:US
Mailing Address - Phone:804-693-5057
Mailing Address - Fax:
Practice Address - Street 1:414 MAIN ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:VA
Practice Address - Zip Code:22572-4291
Practice Address - Country:US
Practice Address - Phone:804-333-3671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-01
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040052071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical