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

Jessica Lee Moore, LICSW

Individual provider Clinical Social Worker · NPI 1750002929

Jessica Lee Moore, LICSW is a Clinical Social Worker in Roseville, Minnesota. Licensed in Minnesota. Registered with an NPI since 2022.

Licensed in
MN
In the registry since
2022
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

2700 Snelling Ave N Ste 400
Roseville, MN 55113-1783
Phone: (763) 210-4698
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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 29099 (MN)

Record details

NPI number1750002929
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedSeptember 7, 2022
Last updated in NPPESNovember 28, 2023
Certification dateNovember 28, 2023

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