Individual
CHERIECE M. MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
399 E MAIN ST, COLUMBUS, OH 43215-5384
(614) 355-8550
(614) 355-8593
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2639
(614) 722-2000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDCIII.151224
OH
104100000X
Social Worker
S.1501378
OH
1041C0700X
Clinical Social Worker
Primary
I.2204090
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1473276
—
OH
Enumeration date
11/27/2017
Last updated
03/14/2023
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