GEORGE J MOORE (NPI# 1245517895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245517895 |
| Entity Type | Individual |
| Full Name | GEORGE J MOORE |
| Credential | LCSW |
| Practice Address |
1445 Seacrest Ln Apt 5 Brookings OR 97415-8133 |
| Practice Telephone | 3158764419 |
| Practice Fax Number | 3156351865 |
| Mailing Telephone | 3158764419 |
| Mailing Fax Number | 3156351865 |
| Enumeration Date | 2011-11-10 |
| Last Update Date | 2020-02-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | 080335 | NY | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
93051 | CA | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
082400 | NY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | GRP MCD # | 02994838 | 01 |
| GRP MCR # | BA1047 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174935423 | George Thomas Moore | Counselor | 1204 Connors Rd, Snohomish, WA 98290-9625 | 2014-05-21 |
| 1275818171 | George Moore | Pharmacist | 304 Silver Grove St, Las Vegas, NV 89144-4104 | 2011-10-12 |
| 1477885770 | George Michael Moore | Dentist | 2002 45th St, Galveston, TX 77550 | 2010-02-11 |
| 1689882581 | George Henry Moore | General Practice | 8120 Cleburne Hwy, Granbury, TX 76049-2207 | 2007-05-21 |
| 1104990654 | George C Moore | Physician Assistant | 701 Park Ave # 08, Minneapolis, MN 55415-1623 | 2006-11-17 |
| 1669551651 | George Bruce Moore | Dentist | 23203 56th Ave W, Mountlake Terrace, WA 98043-4715 | 2006-11-02 |
| 1588604110 | George Walter Moore | Internal Medicine | 1909 214th Street Se, Suite 211, Bothell, WA 98021 | 2006-06-08 |
| 1851340046 | George W Moore | Preventive Medicine | 96 Martin Ter, Glastonbury, CT 06033-2708 | 2006-05-08 |
| 1700378106 | George Moore | Case Manager/Care Coordinator | 1744 Payne Ave, Cleveland, OH 44114 | 2018-05-31 |
| 1407126683 | George L Moore | Dentist | 80 Soldiers Pass Rd, Sedona, AZ 86336-4782 | 2012-01-05 |
| Street Address |
1445 SEACREST LN APT 5 |
| City | BROOKINGS |
| State | OR |
| Zip Code | 97415-8133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013549575 | Christopher Scott Mayo Jr. | Denturist | 937 Chetco Ave Ste. B, Brookings, OR 97415 | 2020-02-12 |
| 1912564329 | Lori A Burkart | Speech-Language Pathologist | Curry Medical Ctr, 500 5th Street, Brookings, OR 97415 | 2019-05-21 |
| 1881144178 | Costa Clinical Psychology, LLC | Social Worker | 625 Spruce St., # 7666, Brookings, OR 97415 | 2016-10-11 |
| 1194173898 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 410 Maple St, Brookings, OR 97415 | 2016-06-03 |
| 1336595784 | Monica Shaw | Case Manager/Care Coordinator | 412 Alder, Brookings, OR 97415 | 2016-05-04 |
| 1639531437 | Ian Leonard | Behavioral Analyst | 450 Sb Chetco River Road, Brookings, OR 97415 | 2016-03-22 |
| 1518201151 | Columbacare Services | Community Based Residential Treatment Facility, Mental Illness | 210 Cove Lane, Brookings, OR 97415 | 2012-11-20 |
| 1699033365 | Sunlight Family Center, LLC | Clinic/Center | 604 Spruce Street, Brookings, OR 97415 | 2012-05-01 |
| 1649544784 | Oregon Coast Wellness Inc. | Clinic/Center | 648 Chetco Ave., Brookings, OR 97415 | 2012-03-07 |
| 1790072544 | Elizabeth A. Nation | Registered Nurse | 96343 Alder Ridge Road, Brookings, OR 97415 | 2011-06-30 |
| Find all providers in zip 97415 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| 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 interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881144178 | Costa Clinical Psychology, LLC | Social Worker | 625 Spruce St., # 7666, Brookings, OR 97415 | 2016-10-11 |
| 1861799553 | Jocelyn Alford Gates | Social Worker | 604 Spruce St., Brookings, OR 97415 | 2011-02-16 |
| 1053624353 | George Sala Jr. | Social Worker | 880 Joshua Ct, Brookings, OR 97415-9394 | 2010-07-15 |
| 1922486901 | Michael Falconer | Social Worker | 601 4th St, Ste 101, Brookings, SD 57006-2065 | 2015-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356942015 | Cynthia Stidd, Lcsw, LLC | Social Worker | 60831 Windsor Dr, Bend, OR 97702-9502 | 2020-11-07 |
| 1932700127 | Teresa Siebenaler Scott | Social Worker | 3990 Sw Collins Way, Suite 202, Lake Owsego, OR 97035 | 2020-11-04 |
| 1063012649 | Kathleen Russell | Social Worker | 7700 Sw Garden Home Rd Apt 23, Portland, OR 97223-7496 | 2020-10-31 |
| 1558961755 | Audrey Schwartz, Lcsw, Lcc | Social Worker | 1518 W 25th Ave, Eugene, OR 97405-1817 | 2020-10-27 |
| 1013516574 | Kathleen Elizabeth Preuss | Social Worker | 14075 Sw Chinn Ln Apt 337, Tigard, OR 97224-0934 | 2020-10-25 |
| 1790384238 | Amy R Duryea Lcsw LLC | Social Worker | 3108 Ne Elizabeth Ct, Bend, OR 97701-7600 | 2020-10-24 |
| 1164021044 | Frederick Dygert, Lcsw | Social Worker | 1445 Willamette St Ste 2b, Eugene, OR 97401-4087 | 2020-10-21 |
| 1275131534 | Alice Hacker | Social Worker | 14702 Se Rhone St, Portland, OR 97236-2557 | 2020-10-09 |
| 1740887249 | Bethany Anne Harvey | Social Worker | 14020 Se Briggs St, Milwaukie, OR 97267-1503 | 2020-10-07 |
| 1598372070 | Kristin Elizabeth Hajny | Social Worker | 9343 Sw Camille Ter, Portland, OR 97223-7042 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.