MEDICARE: MR. DAVID FRANCOIS MOORE MSW, LMSW, LMFT, ACS

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
1	1041C0700X	Clinical Social Worker	6801019639	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0896918	OTHER	MI	BLUE CROSS
2	6801019639	OTHER	MI	LICENSE

General Provider Information

NPI Number	:	1922136720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID FRANCOIS MOORE MSW, LMSW, LMFT, ACS

Provider Business Mailing Address
First Line	:	3437 HAWK WOODS CIR
Second Line	:
City	:	AUBURN HILLS
State	:	MI
Zip	:	48326-1862
Country	:	US
Telephone Number	:	248-875-9562
Fax Number	:	248-608-1448

Provider Business Practice Location Address
First Line	:	3437 HAWK WOODS CIR
Second Line	:
City	:	AUBURN HILLS
State	:	MI
Zip	:	48326-1862
Country	:	US
Telephone Number	:	248-875-9562
Fax Number	:	248-608-1448

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	06/23/2016

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