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General NPI Number Information
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NPI Number | 1346603164
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Entity Type | Individual
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Provider Name | ADRIS MOFFETT LMSW
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Gender | Female
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Dates
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Enumeration Date | 03/30/2016
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 101 S JENNINGS AVE STE 203
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City | FORT WORTH
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State | TX
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Zip | 76104-1118
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Country | US
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Telephone | 318-238-3197
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Fax | 318-238-3199
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Provider Business Mailing Address
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Address Line | PO BOX 414
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City | HASLET
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State | TX
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Zip | 76052-0414
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Country | US
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Telephone | 682-250-0988
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Fax | 682-318-1161
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 12707
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 50606
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License Number State | TX
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