MEDICARE: KRISTIN SIMONE MOORE

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	16171	MD

General Provider Information

NPI Number	:	1669306296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN SIMONE MOORE

Provider Business Mailing Address
First Line	:	18229 PALADIN DR
Second Line	:
City	:	OLNEY
State	:	MD
Zip	:	20832-3010
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18229 PALADIN DR
Second Line	:
City	:	OLNEY
State	:	MD
Zip	:	20832-3010
Country	:	US
Telephone Number	:	240-750-3624
Fax Number	:

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

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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Directions to “ KRISTIN SIMONE MOORE ” Practice Location

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