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General NPI Number Information
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NPI Number | 1396624508
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Entity Type | Organization
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Legal Business Name | MOORE COUNSELING & WELLNESS LLC
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Dates
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Enumeration Date | 09/01/2025
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Last Update Date | 09/01/2025
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Provider Practice Location Address
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Address Line | 17 GARY ST
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City | SOUTH PARIS
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State | ME
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Zip | 04281-1636
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Country | US
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Telephone | 207-418-4101
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Fax | 617-802-5561
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Provider Business Mailing Address
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Address Line | 23 ROCK-O-DUNDEE DRIVE
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City | OXFORD
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State | ME
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Zip | 04270-2973
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Country | US
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Telephone | 207-418-4101
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SIOBHAN MOORE
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Credential | LADC, LCSW
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Telephone | 207-418-4101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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