Provider Demographics
NPI:1407353162
Name:MOYERS, LAURA ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ELIZABETH
Last Name:MOYERS
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 1:2285 ROSE HILL CHURCH LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-7588
Mailing Address - Country:US
Mailing Address - Phone:304-777-9384
Mailing Address - Fax:
Practice Address - Street 1:5570 RICHMOND RD STE 203
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:VA
Practice Address - Zip Code:22974-4421
Practice Address - Country:US
Practice Address - Phone:304-777-9384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-10
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040103661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical