Provider Demographics
NPI:1447245543
Name:MORIN, DOUGLAS G (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:G
Last Name:MORIN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1014 PRISCILLA LANE
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322
Mailing Address - Country:US
Mailing Address - Phone:757-803-3325
Mailing Address - Fax:757-819-6292
Practice Address - Street 1:5040 VIRGINIA BEACH BLVD. SUITE 105
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462
Practice Address - Country:US
Practice Address - Phone:757-985-4740
Practice Address - Fax:757-819-6292
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040023881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA143678OtherANTHEM TRIGON
VA298610OtherMAMSI UNITED HEALTHCARE
VA043842OtherVALUE OPTIONS
VA263116000OtherMAGELLEAN
VA085586OtherSENTARA/OPTIMA
VA263116000OtherMAGELLEAN
VA298610OtherMAMSI UNITED HEALTHCARE