Healthcare Provider Details

I. General information

NPI: 1245162627
Provider Name (Legal Business Name): BRIANNA N MOORER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14535 W INDIAN SCHOOL RD
GOODYEAR AZ
85395-9262
US

IV. Provider business mailing address

14110 W WINDROSE DR
SURPRISE AZ
85379-5544
US

V. Phone/Fax

Practice location:
  • Phone: 602-561-7942
  • Fax:
Mailing address:
  • Phone: 602-561-7942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLMSW-23242
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: