Individual
DAWN FARRELL-MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
107 S 5TH ST, RICHMOND, VA 23219-3825
(804) 819-4000
(804) 819-4268
Mailing address
107 S 5TH ST, RICHMOND, VA 23219-3825
(804) 819-4000
(804) 819-4268
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710101304
VA
1041C0700X
Clinical Social Worker
Primary
0904004005
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4945255
—
VA
Enumeration date
11/27/2007
Last updated
11/27/2007
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