Provider Demographics
NPI:1881309110
Name:MOORE, LINDSAY (LSW, CTP)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:
Last Name:MOORE
Suffix:
Gender:F
Credentials:LSW, CTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 SCHOOL HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:NORMALVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15469-1017
Mailing Address - Country:US
Mailing Address - Phone:724-562-4986
Mailing Address - Fax:
Practice Address - Street 1:150 W CRAWFORD AVE
Practice Address - Street 2:
Practice Address - City:CONNELLSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15425-3527
Practice Address - Country:US
Practice Address - Phone:724-626-9941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-20
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW138850104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty