Provider Demographics
NPI:1609623495
Name:WAITE, BRIAR (LMSW, LCSW-SUPERVISE)
Entity type:Individual
Prefix:
First Name:BRIAR
Middle Name:
Last Name:WAITE
Suffix:
Gender:F
Credentials:LMSW, LCSW-SUPERVISE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8287 CARROLTON RIDGE PL
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-6525
Mailing Address - Country:US
Mailing Address - Phone:804-467-0888
Mailing Address - Fax:
Practice Address - Street 1:5911 W BROAD ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-2219
Practice Address - Country:US
Practice Address - Phone:804-330-6441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09060129091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical