Nicole Sullivan Moore, LCSW
Social Worker, Clinical in Columbus, IN. Individual provider (NPI-1).
NPI number1487910550
StatusActive
Last updated in NPPESApr 3, 2012
Details
- NPI
- 1487910550
- Entity type
- Individual (NPI-1)
- Name
- Ms. Nicole Sullivan Moore
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 3, 2012
- Last updated
- Apr 3, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 34003909A | IN | Yes |
Practice location
1531 13th StSuite 2540
Columbus, IN 47201-1300
Phone 812-372-3745 · Fax 812-372-5367
Mailing address
Po Box 1002Columbus, IN 47202-1002
Phone 812-372-3745 · Fax 812-372-5367
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