MEDICARE: ROXI 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	104100000X	Social Worker	SWB-2025-0779	NM

General Provider Information

NPI Number	:	1942944855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROXI MOORE LCSW

Provider Business Mailing Address
First Line	:	1209 MOUNTAIN ROAD PL NE # 6950
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-7845
Country	:	US
Telephone Number	:	505-221-6630
Fax Number	:

Provider Business Practice Location Address
First Line	:	1209 MOUNTAIN ROAD PL NE # 6950
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-7845
Country	:	US
Telephone Number	:	505-221-6630
Fax Number	:

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

Provider Enumeration Date	:	04/26/2022
Last Update Date	:	12/15/2025

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Directions to “ ROXI MOORE LCSW” Practice Location

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