SearchIllinois104100000X

Lacy Moore, LSW

NPI 1649056417 · on the registry since 2023 · sole proprietor

Practice

Address
612 N 11th St
Quincy, IL 62301
Phone
(217) 224-9484
Fax
(217) 228-8765
Organisation at this address
Siu Healthcare
Siuphysicians & Surgeons, Inc.
Board Of Trustees Of Southern Illinois University
Board Of Trustees Of Southern Illinois University
Inferred from a shared address, not stated in the registry.
Clinicians at this address
87

Registry record

Primary taxonomy
104100000X
104100000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2023-09-06

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 Illinois