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Individual

ANGELA D MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LISW

Contact information

Practice address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 577-5011
Mailing address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 577-5011

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
12076
SC
1041C0700X
Clinical Social Worker
Primary
15785
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1760596480
SC
Enumeration date
11/07/2012
Last updated
02/12/2026
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