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General NPI Number Information
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NPI Number | 1629428735
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Entity Type | Individual
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Provider Name | WINNIE D MOORE LCPC
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Gender | Female
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Dates
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Enumeration Date | 06/20/2016
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 2670 CRAIN HWY STE 105
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City | WALDORF
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State | MD
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Zip | 20601-2820
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Country | US
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Telephone | 240-232-5554
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Fax | 240-366-7076
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Provider Business Mailing Address
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Address Line | 910 JEFFERSON RD
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City | ROCKLEDGE
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State | FL
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Zip | 32955-3510
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Country | US
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Telephone | 240-346-9712
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LC6985
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License Number State | MD
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