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NPI Code Detail

MEDICARE: BUILDING BLOCKS FAMILY COUNSELING

MEDICARE: BUILDING BLOCKS FAMILY COUNSELING
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
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1487118543
Entity Type Code : Organization
Provider Name (Legal Business Name) : BUILDING BLOCKS FAMILY COUNSELING
Provider Business Mailing Address
First Line : 205 S SKINNER AVE UNIT B
Second Line :
City : POOLER
State : GA
Zip : 31322-3221
Country : US
Telephone Number : 912-349-8043
Fax Number :
Provider Business Practice Location Address
First Line : 205 S SKINNER AVE UNIT B
Second Line :
City : POOLER
State : GA
Zip : 31322-3221
Country : US
Telephone Number : 912-349-8043
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ASHLEY M MOORE
Credential : LMFT
Telephone Number : 912-349-8043
Provider Enumeration Date : 01/23/2019
Last Update Date : 01/20/2020

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Directions to “BUILDING BLOCKS FAMILY COUNSELING ” Practice Location

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