Provider Demographics
NPI:1104332931
Name:MOORADIAN, ALICIA MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:MARIE
Last Name:MOORADIAN
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 BOULDER SPRINGS DR APT C1
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-5533
Mailing Address - Country:US
Mailing Address - Phone:804-551-4904
Mailing Address - Fax:
Practice Address - Street 1:6800 PARAGON PL STE 237
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-1651
Practice Address - Country:US
Practice Address - Phone:804-562-9997
Practice Address - Fax:804-918-8284
Is Sole Proprietor?:No
Enumeration Date:2017-12-15
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW034651041C0700X
VA09040101261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical