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General NPI Number Information
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NPI Number | 1053915538
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Entity Type | Individual
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Provider Name | PATRICIA MARIE MOORE LMSW, CASAC2
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Gender | Female
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Dates
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Enumeration Date | 11/25/2020
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 15 FORTUNE RD W
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City | MIDDLETOWN
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State | NY
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Zip | 10941-1625
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Country | US
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Telephone | 888-750-2266
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Fax |
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Provider Business Mailing Address
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Address Line | 103 LINCOLN CT
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City | MILFORD
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State | PA
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Zip | 18337-4434
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Country | US
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Telephone | 845-421-1416
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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