Healthcare Provider Details

I. General information

NPI: 1235487232
Provider Name (Legal Business Name): SHELLEY NIER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2012
Last Update Date: 08/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 RICHMOND RD
CASTLETON VA
22716-2725
US

IV. Provider business mailing address

23 RICHMOND RD
CASTLETON VA
22716-2725
US

V. Phone/Fax

Practice location:
  • Phone: 540-305-9973
  • Fax:
Mailing address:
  • Phone: 540-305-9973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904007358
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: