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General NPI Number Information
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NPI Number | 1477212710
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Entity Type | Individual
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Provider Name | SHAYNA MOORE LCPC
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Gender | Female
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Dates
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Enumeration Date | 12/14/2021
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 10451 MILL RUN CIR
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5577
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Country | US
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Telephone | 443-272-5434
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Fax |
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Provider Business Mailing Address
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Address Line | 3 BELINDA AVE
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City | BALTIMORE
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State | MD
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Zip | 21206-1347
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Country | US
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Telephone | 848-250-4050
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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 | LC15200
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License Number State | MD
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