Provider Demographics
NPI:1083022446
Name:MOORE, MALIKA (LICSW)
Entity Type:Individual
Prefix:MS
First Name:MALIKA
Middle Name:
Last Name:MOORE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4125 ALBEMARLE ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-2105
Mailing Address - Country:US
Mailing Address - Phone:202-895-9453
Mailing Address - Fax:202-895-0245
Practice Address - Street 1:4125 ALBEMARLE ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-2105
Practice Address - Country:US
Practice Address - Phone:202-895-9453
Practice Address - Fax:202-895-0245
Is Sole Proprietor?:No
Enumeration Date:2014-07-30
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500800991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical