Healthcare Provider Details

I. General information

NPI: 1285255638
Provider Name (Legal Business Name): MOORE CONSULTING HOLDINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2020
Last Update Date: 10/11/2025
Certification Date: 10/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 S DILLARD ST STE 120B
WINTER GARDEN FL
34787-3596
US

IV. Provider business mailing address

213 S DILLARD ST STE 120B
WINTER GARDEN FL
34787-3596
US

V. Phone/Fax

Practice location:
  • Phone: 407-734-3338
  • Fax: 407-598-7797
Mailing address:
  • Phone: 407-734-3338
  • Fax: 407-734-3338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL MOORE
Title or Position: MANAGING MEMBER
Credential: LCSW
Phone: 954-980-7828