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General NPI Number Information
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NPI Number | 1114076858
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Entity Type | Individual
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Provider Name | CLEOLA MOORE LPC, LMFT
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Gender | Female
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2900 WESTFORK DR SUITE 200
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City | BATON ROUGE
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State | LA
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Zip | 70827-0010
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Country | US
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Telephone | 225-295-5625
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Fax | 225-775-3594
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Provider Business Mailing Address
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Address Line | 4303 RUE DE VALEUR
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City | BAKER
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State | LA
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Zip | 70714-3839
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Country | US
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Telephone | 225-266-6899
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Fax | 225-775-3594
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1209
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 966
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License Number State | LA
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