Healthcare Provider Details

I. General information

NPI: 1124941620
Provider Name (Legal Business Name): MOORE EMPOWERMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3503 EMMA LN
PASADENA MD
21122-4176
US

IV. Provider business mailing address

3503 EMMA LN
PASADENA MD
21122-4176
US

V. Phone/Fax

Practice location:
  • Phone: 410-913-5922
  • Fax:
Mailing address:
  • Phone: 410-913-5922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: JESSICA MOORE
Title or Position: OWNER
Credential: LCPC
Phone: 410-913-5922