Provider Demographics
NPI:1730071465
Name:SALT OF THE EARTH LCSW PLLC
Entity type:Organization
Organization Name:SALT OF THE EARTH LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIGDALIA
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-701-4661
Mailing Address - Street 1:9 W JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-4209
Mailing Address - Country:US
Mailing Address - Phone:845-204-8135
Mailing Address - Fax:
Practice Address - Street 1:9 W JACKSON AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-4209
Practice Address - Country:US
Practice Address - Phone:845-204-8135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health