Jaclyn Gene Moore, CSW
Social Worker, Clinical in Lexington, KY. Individual provider (NPI-1).
NPI number1104772045
StatusActive
Last updated in NPPESMar 4, 2026
Details
- NPI
- 1104772045
- Entity type
- Individual (NPI-1)
- Name
- Jaclyn Gene Moore
- Credential
- CSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 4, 2026
- Certification date
- Mar 4, 2026
- Last updated
- Mar 4, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 259191 | KY | Yes |
Practice location
80 Codell Dr Ste 130Lexington, KY 40509-1177
Phone 859-309-2877
Mailing address
324 Queensway DrLexington, KY 40502-1007
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