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NPI Code Detail

MEDICARE: SHERRY VON MOORE ALC

MEDICARE: SHERRY VON MOORE ALC
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
1101Y00000XCounselorC2717AAL

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 : 1457014581
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHERRY VON MOORE ALC
Provider Business Mailing Address
First Line : 400 OFFICE PARK DR STE 230
Second Line :
City : MOUNTAIN BRK
State : AL
Zip : 35223-3410
Country : US
Telephone Number : 205-490-6597
Fax Number : 205-905-7099
Provider Business Practice Location Address
First Line : 400 OFFICE PARK DR STE 230
Second Line :
City : MOUNTAIN BRK
State : AL
Zip : 35223-3410
Country : US
Telephone Number : 205-617-6638
Fax Number : 205-905-7099
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2021
Last Update Date : 10/15/2021

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Directions to “ SHERRY VON MOORE ALC” Practice Location

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