Provider Demographics
NPI:1932262649
Name:MOORE, BARRY EARL (LCSW)
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:EARL
Last Name:MOORE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-0432
Mailing Address - Country:US
Mailing Address - Phone:302-897-7448
Mailing Address - Fax:302-836-3306
Practice Address - Street 1:260 CHAPMAN RD
Practice Address - Street 2:SUITE 100B
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5490
Practice Address - Country:US
Practice Address - Phone:302-897-7448
Practice Address - Fax:302-836-3306
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00005041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical