Individual
GAIL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1801 6TH AVE, TROY, NY 12180-3440
(518) 274-5143
(518) 273-1350
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
(518) 525-5634
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
065270
NY
1041C0700X
Clinical Social Worker
083251
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03008266
—
NY
Enumeration date
05/28/2014
Last updated
05/14/2021
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