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Individual
MELISSA I MOOSE
Active
Individual
MELISSA I MOOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LC SW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C004426
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14219
BCBS
NC
01
—
188636
MEDCOST
NC
05
—
6106324
—
NC
Enumeration date
06/20/2006
Last updated
08/22/2025
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