Moore, Mary D

Moore, Mary D is an individual health care provider with primary practice located at 1012 Union St , Bangor ME 04401-3060. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Moore, Mary D can be contacted via phone (207) 945-5247.

Contact Information

Primary practice address
1012 Union St Bangor ME 04401-3060
Phone: (207) 945-5247
Fax: (207) 990-1248
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LC1351 Maine
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LC12013 Maine

Profile Details

NPI number 1134350234
LBN Legal business name Moore, Mary D
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 6th, 2009
Last updated May 5th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134350234 NPPES
Maine MEDICAID 432238199

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