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General NPI Number Information
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NPI Number | 1831724384
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Entity Type | Organization
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Legal Business Name | MOORE PROFESSIONAL COUNSELING, LLC
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Dates
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Enumeration Date | 03/05/2020
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Last Update Date | 08/05/2020
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Provider Practice Location Address
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Address Line | 200 LEAKE ST STE 106
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City | CARTERSVILLE
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State | GA
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Zip | 30120-3562
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Country | US
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Telephone | 470-433-5048
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Fax |
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Provider Business Mailing Address
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Address Line | 200 LEAKE ST STE 106
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City | CARTERSVILLE
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State | GA
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Zip | 30120-3562
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Country | US
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Telephone | 470-433-5048
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Fax |
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Authorized Official
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Title or Position | LPC
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Name | COURTNEY KING MOORE
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Credential | MS
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Telephone | 470-433-5048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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