MEDICARE: CARRIE 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
1	1041C0700X	Clinical Social Worker	CO10018	NC

General Provider Information

NPI Number	:	1700248184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE MOORE LCSW

Provider Business Mailing Address
First Line	:	3835 N FREEWAY BLVD STE 100
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95834-1954
Country	:	US
Telephone Number	:	855-501-1004
Fax Number	:

Provider Business Practice Location Address
First Line	:	2076 VETERANS PKWY STE 220
Second Line	:
City	:	CLAYTON
State	:	NC
Zip	:	27520-5303
Country	:	US
Telephone Number	:	855-501-1004
Fax Number	:

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

Provider Enumeration Date	:	03/24/2016
Last Update Date	:	05/05/2026

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Directions to “ CARRIE MOORE LCSW” Practice Location

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