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Search › Michigan › 1041C0700X

Nydra Moore, LCSW

NPI 1174259287 · on the registry since 2022

Practice

Address
790 Fuller Ave Ne
Grand Rapids, MI 49503
Phone
(616) 336-3909
Fax
(616) 336-8830
Organisation at this address
Kent County Cmh Authority
Kent County Cmh Authority
Kent County Cmh Authority
Kent County Cmh Authority
Kent County Cmh Authority
Inferred from a shared address, not stated in the registry.
Clinicians at this address
389

Additional practice sites

  • 620 Century Ave Sw Ste 120, Grand Rapids, MI

Registry record

Primary taxonomy
1041C0700X
1041C0700X
Licence states on file
MI
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2026-06-26

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan