Provider Demographics
NPI:1356745582
Name:MOOERS, AIRI (LICSW)
Entity type:Individual
Prefix:
First Name:AIRI
Middle Name:
Last Name:MOOERS
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 1:6 OLD ROCHESTER RD STE 106
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-2028
Mailing Address - Country:US
Mailing Address - Phone:603-969-2897
Mailing Address - Fax:
Practice Address - Street 1:6 OLD ROCHESTER RD STE 106
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-2028
Practice Address - Country:US
Practice Address - Phone:603-969-2897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225800000X
NH20371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3078870Medicaid
NH3078870Medicaid