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NPI Code Detail

MEDICARE: MS. MARIA W HALTOM LCSW

MEDICARE:  MS. MARIA W HALTOM  LCSW
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 Worker0904005981VA

General Provider Information

NPI Number : 1457396400
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARIA W HALTOM LCSW
Provider Business Mailing Address
First Line : 2630 HUSSEY LN
Second Line :
City : RICHMOND
State : VA
Zip : 23223-1107
Country : US
Telephone Number : 804-822-2993
Fax Number :
Provider Business Practice Location Address
First Line : 2630 HUSSEY LN
Second Line :
City : RICHMOND
State : VA
Zip : 23223-1107
Country : US
Telephone Number : 804-852-5630
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2006
Last Update Date : 01/23/2019

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Directions to “ MS. MARIA W HALTOM LCSW” Practice Location

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