Rebecca Lynne Migliaccio

Individual provider Active NPI Clinical Social Worker · Moseley, VA

NPI 1003385311 · NPPES record last updated Nov 15, 2018

Key facts

NPI
1003385311
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
111245 (MA)
Practice address
11312 Heartleaf PL
Moseley, VA 23120-1577
Phone
(617) 966-6187
NPI assigned
Nov 15, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
111245MAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 111245 MA Yes

Addresses

Primary practice location

11312 Heartleaf PL
Moseley, VA 23120-1577

Mailing address

11312 Heartleaf PL
Moseley, VA 23120-1577
Phone (617) 966-6187

Other identifiers

IdentifierTypeStateIssuer
123456789MedicaidMA

Other providers in Moseley, VA

All providers in Moseley, VA · Clinical Social Worker in Virginia

Sources for this page

Verify at the official NPI Registry.