Provider Demographics
NPI:1346470168
Name:SECONDI, LORNA MURTLAND (LCSW)
Entity Type:Individual
Prefix:
First Name:LORNA
Middle Name:MURTLAND
Last Name:SECONDI
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 1:7624 BROADREACH DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832
Mailing Address - Country:US
Mailing Address - Phone:434-542-5187
Mailing Address - Fax:434-542-5879
Practice Address - Street 1:60 BUSH RIVER DRIVE
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901
Practice Address - Country:US
Practice Address - Phone:434-392-7049
Practice Address - Fax:434-392-9221
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040071351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1528091063Medicaid