Provider Demographics
NPI:1972870376
Name:CEPHAS, JOAN E (LCSW, LICSW)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:E
Last Name:CEPHAS
Suffix:
Gender:F
Credentials:LCSW, LICSW
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 124
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22555-0124
Mailing Address - Country:US
Mailing Address - Phone:540-850-8189
Mailing Address - Fax:
Practice Address - Street 1:50 KINROSS DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-6579
Practice Address - Country:US
Practice Address - Phone:540-850-8189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-29
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040037721041C0700X
DCLC3023281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical