Basic Information
Provider Information
NPI: 1508207036
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORICI
FirstName: DOREEN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LCSWA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 18 REGENT PARK BLVD STE A
Address2:  
City: ASHEVILLE
State: NC
PostalCode: 288063727
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 18 REGENT PARK BLVD STE A
Address2:  
City: ASHEVILLE
State: NC
PostalCode: 288063727
CountryCode: US
TelephoneNumber: 8285051762
FaxNumber: 8285051763
Other Information
ProviderEnumerationDate: 07/12/2013
LastUpdateDate: 07/12/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XP008173NCY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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