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Individual

CHEVOIS JOHNSON MOORE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
3828 PROVIDENCE RD, ROCKY MOUNT, NC 27803-1158
(252) 451-1878
Mailing address
3828 PROVIDENCE RD, ROCKY MOUNT, NC 27803-1158
(252) 451-1878

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C001361
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6003504
NC
Enumeration date
06/30/2006
Last updated
02/05/2013
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