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MRS. SHELLEY LYNN MARYOTT-MOORE LICSW GMHS CMHS NPI 1720103708


NPI Information

NPI: 1720103708
Provider Name: MRS. SHELLEY LYNN MARYOTT-MOORE, LICSW, GMHS, CMHS
Classification: Social Worker - 1041C0700X
Entity Type: Individual

Specialization: Clinical

Address:
921-14TH AVE.
LONGVIEW, WA
ZIP 98632
Phone: (360) 423-0203
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MRS. Shelley Lynn Maryott-moore, LICSW, GMHS, CMHS is a clinical social worker in Longview, WA. The provider is 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. MRS. Shelley Lynn Maryott-moore, LICSW, GMHS, CMHS NPI is 1720103708. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

921-14TH AVE.
LONGVIEW, WA
ZIP 98632
Phone: (360) 423-0203
Fax: (360) 423-2311

The enumeration date for this NPI number is 3/20/2007 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11041C0700XSocial WorkerClinicalLW00007954WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1LW00007954OTHERWASHINGTONLICSW
28855729MEDICARE ID-TYPE UNSPECIFIEDWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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