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NPI Code Detail

MEDICARE: MS. NICOLE JALAZO HALPERN LCSW, RPT

MEDICARE: MS. NICOLE JALAZO HALPERN LCSW, RPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker0904006327VA

General Provider Information

NPI Number : 1306928726
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NICOLE JALAZO HALPERN LCSW, RPT
Provider Business Mailing Address
First Line : 108A SOUTH COLUMBUS STREET
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22314
Country : US
Telephone Number : 202-253-7503
Fax Number :
Provider Business Practice Location Address
First Line : 108A S COLUMBUS ST
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22314-3051
Country : US
Telephone Number : 202-253-7503
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2006
Last Update Date : 08/02/2024

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