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General NPI Number Information
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NPI Number | 1093453532
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Entity Type | Individual
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Provider Name | THOMAS PHILLIP MOORE II LPCC
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Gender | Male
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Dates
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Enumeration Date | 05/24/2022
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 5095 MIRIAM LN
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City | PARKER
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State | CO
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Zip | 80134-5179
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Country | US
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Telephone | 530-718-6074
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Fax |
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Provider Business Mailing Address
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Address Line | 400 S FARRELL DR
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City | PALM SPRINGS
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State | CA
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Zip | 92262-7964
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Country | US
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Telephone | 760-620-5554
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPCC21613
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License Number State | CA
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