Shelley Lynn Maryott-Moore in Longview - Clinical
Shelley Lynn Maryott-Moore - NPI 1720103708
Shelley Lynn Maryott-Moore is a Clinical in Longview, Washington. Shelley Lynn Maryott-Moore practices all healthcare services and medical treatments related to Clinical. The NPI Number for Shelley Lynn Maryott-Moore is 1720103708. The last update date is 2007-07-08.
Shelley Lynn Maryott-Moore's current location address is Lower Columbia Mental Health/ccga, Longview, Washington. You can contact this provider via phone number 3604230203 and fax number 3604232311. The mailing address for Shelley Lynn Maryott-Moore is Lower Columbia Mental Health/ccga, Longview, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shelley Lynn Maryott-Moore |
|---|---|
| Address | Lower Columbia Mental Health/ccga, Longview, Washington |
| Phone Number | 3604230203 |
| Fax Number | 3604232311 |
| Sole Proprietor | N |
| Credentials | LICSW, GMH |
NPI Number Detail
| NPI Number | 1720103708 |
|---|---|
| Provider Enumeration Date | 2007-03-20 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | Lower Columbia Mental Health/ccga |
|---|---|
| City | Longview |
| State | Washington (WA) |
| Post Code | 98632 |
| Phone Number | 3604230203 |
| Fax Number | 3604232311 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | LW00007954 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| LW00007954 | WA | LICSW |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Shelley Lynn Maryott-Moore by the Centers for Medicare & Medicaid Services?
The Shelley Lynn Maryott-Moore has been issued the NPI (National Provider Identifier) 1720103708 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Can you provide the Shelley Lynn Maryott-Moore's physical address?
The Shelley Lynn Maryott-Moore is physically located at Lower Columbia Mental Health/Ccga, in the city of Longview, WA, with the postal code 98632.
What is Shelley Lynn Maryott-Moore's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Shelley Lynn Maryott-Moore is Clinical, and the taxonomy code that categorizes this field of expertise is 1041C0700X.
On what date did the Shelley Lynn Maryott-Moore receive the assignment of its 1720103708 from the Centers for Medicare & Medicaid Services?
The Shelley Lynn Maryott-Moore was issued its 1720103708 by the Centers for Medicare & Medicaid Services on 2007-03-20.
As of what date were the details related to Shelley Lynn Maryott-Moore most recently updated or revised?
The information pertaining to Shelley Lynn Maryott-Moore, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.