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General NPI Number Information
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NPI Number | 1467243048
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Entity Type | Individual
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Provider Name | CARLEY ELIZABETH MOORE LMSW
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Gender | Female
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Dates
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Enumeration Date | 05/14/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 367 PRINCE AVE UNIT R
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City | ATHENS
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State | GA
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Zip | 30601-2471
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Country | US
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Telephone | 762-499-5596
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Fax |
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Provider Business Mailing Address
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Address Line | 130 W LAKE DR
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City | ATHENS
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State | GA
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Zip | 30606-4722
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Country | US
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Telephone | 706-372-8861
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | MSW012126
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License Number State | GA
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