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NPI Code Detail

MEDICARE: JACE NICHOLE MOORE LPCC

MEDICARE: JACE NICHOLE MOORE LPCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorE.2607197OH

General Provider Information

NPI Number : 1205675717
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACE NICHOLE MOORE LPCC
Provider Business Mailing Address
First Line : 5050 MADISON RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45227-1491
Country : US
Telephone Number : 513-272-2800
Fax Number : 513-272-2807
Provider Business Practice Location Address
First Line : 5050 MADISON RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45227-1491
Country : US
Telephone Number : 513-272-2800
Fax Number : 513-272-2807
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2024
Last Update Date : 06/08/2026

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Directions to “ JACE NICHOLE MOORE LPCC” Practice Location

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