Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Elyza Moore, LICSW

Individual provider Clinical Social Worker · NPI 1003575002

Elyza Moore, LICSW is a Clinical Social Worker in Burlington, Vermont. Licensed in Vermont. Registered with an NPI since 2021.

Licensed in
VT
In the registry since
2021
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

1138 Pine St
Burlington, VT 05401-5353
Phone: (802) 488-6000
Fax: (802) 488-6919
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 089.0124729 (VT)

Record details

NPI number1003575002
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedDecember 17, 2021
Last updated in NPPESApril 29, 2025
Certification dateApril 29, 2025
Mailing address102 S Winooski Ave, Burlington, VT 05401-7406

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