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NPI Code Detail

MEDICARE: MS. CLEOLA MOORE LPC, LMFT

MEDICARE: MS. CLEOLA MOORE LPC, LMFT
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
1101YP2500XProfessional Counselor1209LA
2106H00000XMarriage & Family Therapist966LA

General Provider Information

NPI Number : 1114076858
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CLEOLA MOORE LPC, LMFT
Provider Business Mailing Address
First Line : 4303 RUE DE VALEUR
Second Line :
City : BAKER
State : LA
Zip : 70714-3839
Country : US
Telephone Number : 225-266-6899
Fax Number : 225-775-3594
Provider Business Practice Location Address
First Line : 2900 WESTFORK DR
Second Line : SUITE 200
City : BATON ROUGE
State : LA
Zip : 70827-0010
Country : US
Telephone Number : 225-295-5625
Fax Number : 225-775-3594
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2007
Last Update Date : 09/11/2025

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