Provider Demographics
NPI:1275574857
Name:MORELAND, PAUL;A S (MSW/LISW-S/QCSW)
Entity Type:Individual
Prefix:MS
First Name:PAUL;A
Middle Name:S
Last Name:MORELAND
Suffix:
Gender:F
Credentials:MSW/LISW-S/QCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1855 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-1135
Mailing Address - Country:US
Mailing Address - Phone:614-257-5914
Mailing Address - Fax:614-257-5903
Practice Address - Street 1:65 MESSIMER DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-1874
Practice Address - Country:US
Practice Address - Phone:740-522-8477
Practice Address - Fax:740-522-2941
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-310581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical