Healthcare Provider Details

I. General information

NPI: 1689703092
Provider Name (Legal Business Name): MARTHA HILL MOORE LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 HOSPITAL DR STE 5A
HENDERSONVILLE NC
28792-5247
US

IV. Provider business mailing address

45 WINDJAMMER WAY
HENDERSONVILLE NC
28792-9880
US

V. Phone/Fax

Practice location:
  • Phone: 828-684-1115
  • Fax: 828-687-6064
Mailing address:
  • Phone: 209-605-8983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9933
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: