Healthcare Provider Details

I. General information

NPI: 1346470168
Provider Name (Legal Business Name): LORNA MURTLAND SECONDI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2009
Last Update Date: 07/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 BUSH RIVER DRIVE
FARMVILLE VA
23901
US

IV. Provider business mailing address

7624 BROADREACH DRIVE
CHESTERFIELD VA
23832
US

V. Phone/Fax

Practice location:
  • Phone: 434-392-7049
  • Fax: 434-392-9221
Mailing address:
  • Phone: 434-542-5187
  • Fax: 434-542-5879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904007135
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: