Lorelei Jean Moore, LLMSW
Individual provider Active NPI Social Worker · Marne, MI
NPI 1720714280 · NPPES record last updated Jul 27, 2022
Key facts
- NPI
- 1720714280
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- Practice address
- 15146 16TH Ave
Marne, MI 49435-9605 - Phone
- (616) 288-6970
- NPI assigned
- Jul 27, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Counseling Services PLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | MI | Yes |
Addresses
Primary practice location
15146 16TH Ave
Marne, MI 49435-9605
Mailing address
15146 16TH Ave
Marne, MI 49435-9605
Phone (616) 288-6970
Other practice location 1
1003 Parchment Dr SE
Grand Rapids, MI 49546-3664
Phone (616) 957-7700
Other providers in Marne, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.