Moore, Martha W.
Moore, Martha W. is an individual health care provider with primary practice located at 55 Lake Ave N Department Of Psychiatry, Worcester MA 01655-0002. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Moore, Martha W. can be contacted via phone (508) 334-3240.Contact Information
Primary practice address
55 Lake Ave N Department Of Psychiatry
Worcester MA 01655-0002
Phone: (508) 334-3240
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 106105 | Massachusetts |
Profile Details
| NPI number | 1225016678 |
|---|---|
| LBN Legal business name | Moore, Martha W. |
| Credentials | LICSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 5th, 2006 |
| Last updated | Jan 25th, 2010 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225016678 | NPPES |
| Massachusetts | MEDICAID | 1854763 |
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