Individual provider · Type 1 NPI

Jaclyn Gene Moore, CSW

Clinical Social Worker · Lexington, KY

NPI number 1104772045 Active

Practice location

80 Codell Dr Ste 130
Lexington, KY 40509-1177

Call (859) 309-2877 Map

Mailing address

324 Queensway Dr
Lexington, KY 40502-1007

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X259191 (KY)

Clinical Social Worker: 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, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1104772045

Jaclyn Gene Moore, CSW's National Provider Identifier is 1104772045, issued on Mar 4, 2026. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Lexington, KY. The record was last updated on Mar 4, 2026.