Moore, Carolyn Mae

Moore, Carolyn Mae is an individual health care provider with primary practice located at 1600 S Main St , Lebanon OR 97355-3109. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Moore, Carolyn Mae can be contacted via phone (541) 451-5932.

Contact Information

Primary practice address
1600 S Main St Lebanon OR 97355-3109
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X L4204 Oregon

Profile Details

NPI number 1720068182
LBN Legal business name Moore, Carolyn Mae
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 20th, 2006
Last updated Mar 5th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1720068182 NPPES
Oregon MEDICAID 500612327

Popular Providers