Provider Demographics
NPI:1881034320
Name:BRUMSEY-MOORE, LINDA LEE (LCSWA)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:LEE
Last Name:BRUMSEY-MOORE
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4014 TIMMERMAN DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-9749
Mailing Address - Country:US
Mailing Address - Phone:252-337-6112
Mailing Address - Fax:
Practice Address - Street 1:1001 NAVAHO DR
Practice Address - Street 2:SUITE 101
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7335
Practice Address - Country:US
Practice Address - Phone:919-871-1178
Practice Address - Fax:919-872-1170
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0080191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical