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NPI Code Detail

MEDICARE: MS. LINDA G MOORE LCSW

MEDICARE: MS. LINDA G MOORE LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker280653-3501UT
2101YM0800XMental Health Counselor280653-3501UT

General Provider Information

NPI Number : 1518130145
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LINDA G MOORE LCSW
Provider Business Mailing Address
First Line : 150 E 700 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84111-3806
Country : US
Telephone Number : 801-364-8080
Fax Number : 801-364-8098
Provider Business Practice Location Address
First Line : 150 E 700 S
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84111-3806
Country : US
Telephone Number : 801-364-8080
Fax Number : 801-364-8098
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2008
Last Update Date : 06/22/2022

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Directions to “ MS. LINDA G MOORE LCSW” Practice Location

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