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General NPI Number Information
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NPI Number | 1366334153
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Entity Type | Individual
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Provider Name | REBBA A MOORE LPC-R
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Gender | Female
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 4250 FAIRFAX DR STE 600
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City | ARLINGTON
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State | VA
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Zip | 22203-1665
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Country | US
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Telephone | 240-748-0743
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 TUNLAW RD NW APT 1004
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City | WASHINGTON
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State | DC
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Zip | 20007-4845
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Country | US
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Telephone | 651-323-7841
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0704016456
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0704016456
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License Number State | VA
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