Provider Demographics
NPI:1497946156
Name:BROWNING-MOORE, CORNELIA (LCSW)
Entity Type:Individual
Prefix:
First Name:CORNELIA
Middle Name:
Last Name:BROWNING-MOORE
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 1:867 WEYANOKE LN
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-9311
Mailing Address - Country:US
Mailing Address - Phone:757-344-2294
Mailing Address - Fax:
Practice Address - Street 1:809 MAIN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23605-1090
Practice Address - Country:US
Practice Address - Phone:757-344-2294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040038931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA014650C90Medicare PIN