MEDICARE: DR. BARBARA C 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	101YA0400X	Addiction (Substance Use Disorder) Counselor	ADC-012052-2015	FL
2	1041C0700X	Clinical Social Worker	006444	CT
3	1041C0700X	Clinical Social Worker	SW 6270	FL

General Provider Information

NPI Number	:	1841512100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBARA C MOORE LCSW

Provider Business Mailing Address
First Line	:	6208 SHERMAN TER
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33876-6499
Country	:	US
Telephone Number	:	203-606-4767
Fax Number	:

Provider Business Practice Location Address
First Line	:	6208 SHERMAN TER
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33876-6499
Country	:	US
Telephone Number	:	203-606-4767
Fax Number	:

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

Provider Enumeration Date	:	02/26/2010
Last Update Date	:	07/02/2021

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