Provider Demographics
NPI:1972039865
Name:MOORMAN, ANNA FAITH (MSW, LSW)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:FAITH
Last Name:MOORMAN
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1242 ARBOR AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45420-1907
Mailing Address - Country:US
Mailing Address - Phone:937-269-7006
Mailing Address - Fax:
Practice Address - Street 1:1335 DUBLIN RD
Practice Address - Street 2:SUITE 212 C
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-1000
Practice Address - Country:US
Practice Address - Phone:614-437-9910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.09012611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical