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General NPI Number Information
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NPI Number | 1932237336
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Entity Type | Individual
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Provider Name | KATHLEEN P MOORE LADC PLMHP
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Gender | Female
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2009 FRANKLIN ST
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City | BELLEVUE
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State | NE
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Zip | 68005-5055
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Country | US
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Telephone | 402-292-7335
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Fax | 402-292-2110
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Provider Business Mailing Address
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Address Line | 10018 S 14TH ST
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City | BELLEVUE
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State | NE
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Zip | 68123-2460
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Country | US
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Telephone | 402-292-1208
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Fax | 402-292-2110
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 84
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 7143
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License Number State | NE
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