Provider Demographics
NPI:1649312760
Name:MCCAULEY, JENNIFER L (LCSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:MCCAULEY
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 1:4801 COX RD STE 205
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-6803
Mailing Address - Country:US
Mailing Address - Phone:804-796-0790
Mailing Address - Fax:804-796-0799
Practice Address - Street 1:4801 COX RD STE 205
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-6803
Practice Address - Country:US
Practice Address - Phone:804-796-0790
Practice Address - Fax:804-796-0799
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040064841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA294810OtherANTHEM
VAO802966MOtherOPTIMA
VA294810OtherANTHEM
VA01279C36Medicare PIN