Provider Demographics
NPI:1467243048
Name:MOORE, CARLEY ELIZABETH (LMSW)
Entity type:Individual
Prefix:
First Name:CARLEY
Middle Name:ELIZABETH
Last Name:MOORE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CARLEY
Other - Middle Name:MOORE
Other - Last Name:REEVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:130 W LAKE DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-4722
Mailing Address - Country:US
Mailing Address - Phone:706-372-8861
Mailing Address - Fax:
Practice Address - Street 1:367 PRINCE AVE UNIT R
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30601-2471
Practice Address - Country:US
Practice Address - Phone:762-499-5596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW012126104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker