Provider Demographics
NPI:1700462660
Name:MCCOOL, SAFFIRE NICOLE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SAFFIRE
Middle Name:NICOLE
Last Name:MCCOOL
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 1:788 DEER LAKE DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-4775
Mailing Address - Country:US
Mailing Address - Phone:619-630-5209
Mailing Address - Fax:
Practice Address - Street 1:788 DEER LAKE DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-4775
Practice Address - Country:US
Practice Address - Phone:619-630-5209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1086191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical