Provider Demographics
NPI:1376983890
Name:MOORE, MARGARET (LICSW)
Entity Type:Individual
Prefix:
First Name:MARGARET
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 1:123 LITTLETON RD
Mailing Address - Street 2:UNIT 16
Mailing Address - City:AYER
Mailing Address - State:MA
Mailing Address - Zip Code:01432-1734
Mailing Address - Country:US
Mailing Address - Phone:617-872-5418
Mailing Address - Fax:
Practice Address - Street 1:123 LITTLETON RD
Practice Address - Street 2:UNIT 16
Practice Address - City:AYER
Practice Address - State:MA
Practice Address - Zip Code:01432-1734
Practice Address - Country:US
Practice Address - Phone:617-872-5418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1147571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical