Individual provider · Type 1 NPI

Lisa Lynelle Moore, MSW, LICSW, PhD

Clinical Social Worker · Minneapolis, MN

NPI number 1336462324 Active

Practice location

2637 27th Ave S Ste 231
Minneapolis, MN 55406-3196

Call (503) 528-4033 Map

Mailing address

1304 Liberty Ct
Northfield, MN 55057-2915

Specialties and licenses

Taxonomy	Code	License
Clinical Social Worker Primary	1041C0700X	115630 (MA)

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 1336462324

Lisa Lynelle Moore, MSW, LICSW, PhD's National Provider Identifier is 1336462324, issued on Mar 5, 2010. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Minneapolis, MN. The record was last updated on May 4, 2018.