Provider Demographics
NPI:1922699602
Name:MOORE, CAROLYN MERCEDES (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:MERCEDES
Last Name:MOORE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9481 DOWDEN RD
Mailing Address - Street 2:APT 5102
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832
Mailing Address - Country:US
Mailing Address - Phone:850-450-3146
Mailing Address - Fax:
Practice Address - Street 1:2501 N. ORANGE AVE, ADVENT HEALTH PALLIATIVE CARE
Practice Address - Street 2:SUITE 235
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804
Practice Address - Country:US
Practice Address - Phone:407-303-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL169651041C0700X
FLSW169651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical