MEDICARE: NICOLE GARLAND 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
1	1041C0700X	Clinical Social Worker	ISW11497	FL
2	1041C0700X	Clinical Social Worker	SW17666	FL
3	1041C0700X	Clinical Social Worker	0904012664	VA

General Provider Information

NPI Number	:	1962933408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE GARLAND LCSW

Provider Business Mailing Address
First Line	:	7846 FOREST HILL AVE STE A
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23225-1931
Country	:	US
Telephone Number	:	804-554-2121
Fax Number	:

Provider Business Practice Location Address
First Line	:	7846 FOREST HILL AVE STE A
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23225-1931
Country	:	US
Telephone Number	:	804-554-2121
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2017
Last Update Date	:	07/18/2022

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