Provider Demographics
NPI:1376723395
Name:MORLEY, NICOLA J (LCSW)
Entity Type:Individual
Prefix:
First Name:NICOLA
Middle Name:J
Last Name:MORLEY
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 1:297 INDEPENDENCE BLVD
Mailing Address - Street 2:STE 218
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-2911
Mailing Address - Country:US
Mailing Address - Phone:757-385-0594
Mailing Address - Fax:757-473-5235
Practice Address - Street 1:297 INDEPENDENCE BLVD
Practice Address - Street 2:STE 218
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-2911
Practice Address - Country:US
Practice Address - Phone:757-385-0594
Practice Address - Fax:757-473-5235
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040066321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004945395OtherVAPRIMER
VAO803411OtherOPTIMA PROVIDER NUMBER
VA342390OtherANTHEM PROVIDER NUMBER
VA004945395Medicaid
VA342390OtherANTHEM PROVIDER NUMBER