Provider Demographics
NPI:1609015908
Name:MOORE, ANNE RANKIN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:RANKIN
Last Name:MOORE
Suffix:
Gender:F
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:PO BOX 14608
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27415-4608
Mailing Address - Country:US
Mailing Address - Phone:336-274-1538
Mailing Address - Fax:336-333-9399
Practice Address - Street 1:1004 YANCEYVILLE ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-7842
Practice Address - Country:US
Practice Address - Phone:336-274-1538
Practice Address - Fax:336-333-9399
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0060471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical