Virginia Ann Nesheim-Moore, LCSW
Individual provider Active NPI Social Worker · Black, MO
NPI 1548412901 · NPPES record last updated Oct 16, 2008
Key facts
- NPI
- 1548412901
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 2007001603 (MO)
- Practice address
- RR 1 Box 127
Black, MO 63625-9704 - Phone
- (573) 269-4291
- Fax
- (573) 269-4202
- NPI assigned
- Oct 16, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2007001603 | MO | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Springs Enterprises, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 2007001603 | MO | Yes |
Addresses
Primary practice location
RR 1 Box 127
Black, MO 63625-9704
Mailing address
RR 1 Box 127
Black, MO 63625-9704
Phone (573) 269-4291
Other providers in Black, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.