Healthcare Provider Details

I. General information

NPI: 1104332931
Provider Name (Legal Business Name): ALICIA MARIE MOORADIAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2017
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 PARAGON PL STE 237
RICHMOND VA
23230-1651
US

IV. Provider business mailing address

721 BOULDER SPRINGS DR APT C1
NORTH CHESTERFIELD VA
23225-5533
US

V. Phone/Fax

Practice location:
  • Phone: 804-562-9997
  • Fax: 804-918-8284
Mailing address:
  • Phone: 804-551-4904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW03465
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904010126
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: