Provider Demographics
NPI:1114431467
Name:BILLY, ALICIA MORENO
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:MORENO
Last Name:BILLY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 CEDAR CREEK GRADE, SUITE 202
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER, VA
Mailing Address - State:VA
Mailing Address - Zip Code:22601
Mailing Address - Country:US
Mailing Address - Phone:540-450-2734
Mailing Address - Fax:
Practice Address - Street 1:817 CEDAR CREEK GRADE, SUITE 202
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601
Practice Address - Country:US
Practice Address - Phone:540-450-2734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-24
Last Update Date:2017-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040101301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical