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NPI Code Detail

MEDICARE: DECEIL LEANNE MOORE LCSW

MEDICARE: DECEIL LEANNE MOORE LCSW
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
11041C0700XClinical Social Worker34003550AIN

General Provider Information

NPI Number : 1699727420
Entity Type Code : Individual
Provider Name (Legal Business Name) : DECEIL LEANNE MOORE LCSW
Provider Business Mailing Address
First Line : 31 6TH ST
Second Line :
City : MALONE
State : NY
Zip : 12953-1246
Country : US
Telephone Number : 518-483-3261
Fax Number : 518-483-3383
Provider Business Practice Location Address
First Line : 31 6TH ST
Second Line :
City : MALONE
State : NY
Zip : 12953-1246
Country : US
Telephone Number : 518-483-3261
Fax Number : 518-483-3383
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2006
Last Update Date : 01/06/2017

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Directions to “ DECEIL LEANNE MOORE LCSW” Practice Location

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