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Organization
NICOLE MOODY LLC
Active
Organization
NICOLE MOODY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE L MOODY LMSW (OWNER)
(517) 515-4114
Entity
Organization
Contact information
Practice address
541 E GRAND RIVER AVE STE A1, EAST LANSING, MI 48823-4445
(517) 515-4114
Mailing address
1144 WOODWIND TRL, HASLETT, MI 48840-8955
(517) 515-4114
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801090018
MI
Other
Enumeration date
01/30/2015
Last updated
04/14/2022
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