Provider Demographics
NPI:1487384376
Name:DANGERFIELD, ERIN FORREST (LCSW)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:FORREST
Last Name:DANGERFIELD
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 1:13512 QUEENSGATE RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-4428
Mailing Address - Country:US
Mailing Address - Phone:804-314-2342
Mailing Address - Fax:
Practice Address - Street 1:13512 QUEENSGATE RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-4428
Practice Address - Country:US
Practice Address - Phone:804-314-2342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1041S0200X
VAPPS-06046201041S0200X
1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool