Provider Demographics
NPI:1649723065
Name:DROZD, NICOLE (MSW, MT-BC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:DROZD
Suffix:
Gender:F
Credentials:MSW, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 KIDD BLVD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-5214
Mailing Address - Country:US
Mailing Address - Phone:315-489-1590
Mailing Address - Fax:
Practice Address - Street 1:4854 HAYGOOD RD STE 100
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-5351
Practice Address - Country:US
Practice Address - Phone:757-371-2700
Practice Address - Fax:757-644-1476
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY09782225A00000X
VA09040163761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist