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NPI Code Detail

MEDICARE: MICHELLE P MOORE LPC

MEDICARE: MICHELLE P MOORE LPC
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 Counselor2019030966MO

General Provider Information

NPI Number : 1588214274
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE P MOORE LPC
Provider Business Mailing Address
First Line : 1247 WATTS AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63130-1831
Country : US
Telephone Number : 314-706-0398
Fax Number : 314-919-4859
Provider Business Practice Location Address
First Line : 1001 LYNCH ST
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63118-1818
Country : US
Telephone Number : 314-535-5600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2019
Last Update Date : 03/12/2026

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Directions to “ MICHELLE P MOORE LPC” Practice Location

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