Provider Demographics
NPI:1154625945
Name:MCKENZIE, VARNELL HAIRSTON (SOCIAL WORKER)
Entity type:Individual
Prefix:MRS
First Name:VARNELL
Middle Name:HAIRSTON
Last Name:MCKENZIE
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3781 BANISTER RD
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:VA
Mailing Address - Zip Code:24531-5061
Mailing Address - Country:US
Mailing Address - Phone:434-432-2236
Mailing Address - Fax:
Practice Address - Street 1:932 E MEADOW RD
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-3639
Practice Address - Country:US
Practice Address - Phone:434-432-2236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker