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NPI Code Detail

MEDICARE: MR. DAVID ISAAC MOORE LPC, NCC, ADC

MEDICARE: MR. DAVID ISAAC MOORE LPC, NCC, ADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care CoordinatorOR
2101YM0800XMental Health Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023502085
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID ISAAC MOORE LPC, NCC, ADC
Provider Business Mailing Address
First Line : 208 E 1ST AVE
Second Line :
City : EASLEY
State : SC
Zip : 29640-3039
Country : US
Telephone Number : 864-898-5800
Fax Number : 864-898-5804
Provider Business Practice Location Address
First Line : 208 E 1ST AVE
Second Line :
City : EASLEY
State : SC
Zip : 29640-3039
Country : US
Telephone Number : 864-898-5800
Fax Number : 864-898-5804
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2018
Last Update Date : 02/24/2025

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