Nicolette Staton Moon in Glen Allen - Clinical
Nicolette Staton Moon - NPI 1346384658
Nicolette Staton Moon is a Clinical in Glen Allen, Virginia. Nicolette Staton Moon practices all healthcare services and medical treatments related to Clinical. The NPI Number for Nicolette Staton Moon is 1346384658. The last update date is 2008-09-26.
Nicolette Staton Moon's current location address is 10299 Woodman Rd, Glen Allen, Virginia. You can contact this provider via phone number 8047278500 and fax number 8047278580. The mailing address for Nicolette Staton Moon is 10299 Woodman Rd, Glen Allen, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Nicolette Staton Moon |
|---|---|
| Address | 10299 Woodman Rd, Glen Allen, Virginia |
| Phone Number | 8047278500 |
| Fax Number | 8047278580 |
| Sole Proprietor | N |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1346384658 |
|---|---|
| Provider Enumeration Date | 2007-02-19 |
| Last Updated Date | 2008-09-26 |
Provider Mailing Address Detail
| Address | 10299 Woodman Rd |
|---|---|
| City | Glen Allen |
| State | Virginia (VA) |
| Post Code | 230604419 |
| Phone Number | 8047278500 |
| Fax Number | 8047278580 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 904003308 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| O89418 | VA | OPTIMA | |
| 4945131 | VA | VIRGINIA PREMIER | |
| 205825 | VA | ANTHEM | |
| 263166-000 | VA | MAGELLAN | |
| 2169372 | VA | MAMSI |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Nicolette Staton Moon by the Centers for Medicare & Medicaid Services?
The Nicolette Staton Moon has been issued the NPI (National Provider Identifier) 1346384658 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you share the physical location details of Nicolette Staton Moon?
The Nicolette Staton Moon is situated at 10299 Woodman Rd, in the city of Glen Allen, state of VA, with the zip code 230604419.
What is Nicolette Staton Moon's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Nicolette Staton Moon is Clinical, and the corresponding taxonomy classification code for this specialized field is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1346384658 to Nicolette Staton Moon?
The Centers for Medicare & Medicaid Services originally issued the 1346384658 to Nicolette Staton Moon on 2007-02-19.
When was the information related to Nicolette Staton Moon most recently updated or refreshed?
The details pertaining to the Nicolette Staton Moon, including its address, specialty, and other relevant information, were last updated or refreshed on 2008-09-26.
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