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General NPI Number Information
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NPI Number | 1407062466
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Entity Type | Individual
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Provider Name | DAWN MARIE MOORE M.S., MFT, LADC
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Gender | Female
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 601 N PECOS RD PSYCHOLOGICAL SERVICES UNIT
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City | LAS VEGAS
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State | NV
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Zip | 89101-2408
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Country | US
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Telephone | 702-455-2202
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Fax | 702-455-0185
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Provider Business Mailing Address
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Address Line | 7513 LONGHORN LODGE AVE
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City | LAS VEGAS
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State | NV
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Zip | 89113-4010
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Country | US
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Telephone | 702-363-1471
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 01178-L
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License Number State | NV
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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 | 0992
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License Number State | NV
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