Provider Demographics
NPI:1710025853
Name:MOORE, ROWAN GILLIAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ROWAN
Middle Name:GILLIAN
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 1:607 EASTON RD STE B2
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-2536
Mailing Address - Country:US
Mailing Address - Phone:267-809-1689
Mailing Address - Fax:215-628-3919
Practice Address - Street 1:607 EASTON RD STE B2
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-2536
Practice Address - Country:US
Practice Address - Phone:267-809-1689
Practice Address - Fax:215-628-3919
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
PACW0137371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical