Individual provider · Type 1 NPI
Michelle Glynise Moore, EARLY INTERVENTION P
Clinical Social Worker · Blue Island, IL
Practice location
PO Box 658
Blue Island, IL 60406
Mailing address
246 E Janata Blvd Ste 111
Lombard, IL 60148-5317
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker | 104100000X | 150107720 (IL) |
| Early Intervention Provider Agency | 252Y00000X | None listed |
| Clinical Social Worker Primary | 1041C0700X | 149027689 (IL) |
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 1760649628
Michelle Glynise Moore, EARLY INTERVENTION P's National Provider Identifier is 1760649628, issued on May 19, 2008. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Blue Island, IL. The record was last updated on May 11, 2026.