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General NPI Number Information
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NPI Number | 1558872283
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Entity Type | Individual
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Provider Name | GEOFFREY KURT MOORE PHD, LPC
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Gender | Male
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Dates
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Enumeration Date | 10/20/2017
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Last Update Date | 10/20/2017
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Provider Practice Location Address
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Address Line | 2150 W 29TH AVE STE 330
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City | DENVER
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State | CO
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Zip | 80211-3889
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Country | US
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Telephone | 303-449-4162
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Fax |
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Provider Business Mailing Address
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Address Line | 1499 BLAKE ST APT 3S
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City | DENVER
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State | CO
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Zip | 80202-1358
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Country | US
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Telephone | 303-449-4162
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 3260
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License Number State | CO
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