Lacey Moore, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

44SL06935200 Issued in NJ

Practice address

131 Delaware Ave
Woodbury, NJ 08096

Phone

(856) 537-5081

Fax

(856) 415-7574

NPI assigned

May 23, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Therapy and Consultation Services

  • Community/Behavioral Health Agency
  • Woodbury, NJ
  • NPI 1730239450
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1477392033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LUPTON AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080965901",
            "telephone_number": "856-693-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 DELAWARE AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "08096",
            "telephone_number": "856-537-5081",
            "fax_number": "856-415-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LACEY",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL06935200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000691",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Z Mock, LPC
• Melissa Mohr, LAC
• Dominique Montague, PA-C
• Michelle A Montanino, LSW
• Michael E Monte Carlo, DO
• Linda Moore, LSW
• Nicole Moore, LCSW
• Harry James Morgan, D.C.
• Jean Haig Morgan, LSW
• Melissa Morina, FNP-C

• Social Worker in Woodbury, NJ
• Providers in Woodbury, NJ by specialty
• Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.