Moon, Nicolette Staton

Moon, Nicolette Staton is an individual health care provider with primary practice located at 10299 Woodman Rd , Glen Allen VA 23060-4419. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Moon, Nicolette Staton can be contacted via phone (804) 727-8500.

Contact Information

Primary practice address
10299 Woodman Rd Glen Allen VA 23060-4419
Phone: (804) 727-8500
Fax: (804) 727-8580
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 0904003308 Virginia

Profile Details

NPI number 1346384658
LBN Legal business name Moon, Nicolette Staton
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 19th, 2007
Last updated Sep 26th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1346384658 NPPES
Virginia Other O89418 OPTIMA
Virginia Other 4945131 OPTIMA
Virginia Other 205825 OPTIMA
Virginia Other 263166-000 OPTIMA
Virginia Other 2169372 OPTIMA

Popular Providers