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General NPI Number Information
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NPI Number | 1871360115
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Entity Type | Organization
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Legal Business Name | MOORE PSYCHOTHERAPY LLC
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Dates
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Enumeration Date | 12/06/2023
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 1750 WEWATTA ST UNIT 1825
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City | DENVER
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State | CO
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Zip | 80202-6698
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Country | US
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Telephone | 608-473-3575
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Fax |
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Provider Business Mailing Address
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Address Line | 1750 WEWATTA ST UNIT 1825
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City | DENVER
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State | CO
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Zip | 80202-6698
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Country | US
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Telephone | 608-473-3575
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | LUCAS MOORE
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Credential | LCSW, SUD, ICS, ACS
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Telephone | 608-473-3575
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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 |
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License Number State |
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