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Individual
SEAN SMITH-MOORE
Active
Individual
SEAN SMITH-MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
34978
IL
104100000X
Social Worker
20792
MD
104100000X
Social Worker
LG50081367
DC
1041C0700X
Clinical Social Worker
Primary
149019678
IL
Other
Enumeration date
11/19/2015
Last updated
04/22/2021
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