Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Matthew Moore, LICSW, LCSW, LISW-CP

Individual provider Clinical Social Worker · NPI 1558829234

Matthew Moore, LICSW, LCSW, LISW-CP is a Clinical Social Worker in Wake Forest, North Carolina. Qualified in 2017, 9 years ago. Licensed in North Carolina, South Carolina, Utah and Washington.

Years since qualifying
9
Licensed in
NC, SC, UT, WA
In the registry since
2019
Specialties on file
4
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

2006 S Main St Ste 204
Wake Forest, NC 27587-9391
Phone: (360) 844-0462
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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 LW61418510 (WA)
Clinical Social Worker Taxonomy 1041C0700X · Licence 14298209-3501 (UT)
Clinical Social Worker Taxonomy 1041C0700X · Licence C017890 (NC)
Clinical Social Worker Taxonomy 1041C0700X · Licence 17200 (SC)

Record details

NPI number1558829234
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW , LCSW , LISW-CP
Sole proprietorNo
NPI enumeratedMarch 12, 2019
Last updated in NPPESAugust 7, 2026
Certification dateAugust 7, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Not indicated

Other providers in Wake Forest