Provider Demographics
NPI:1023195211
Name:J.R. MOORE & ASSOCIATES LLC
Entity Type:Organization
Organization Name:J.R. MOORE & ASSOCIATES LLC
Other - Org Name:J.R. MOORE COUNSELING & PSYCHOLOGICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, S-LPC, NCC
Authorized Official - Phone:2052-936-1657
Mailing Address - Street 1:PO BOX 11642
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35202-1642
Mailing Address - Country:US
Mailing Address - Phone:205-703-2020
Mailing Address - Fax:205-957-6601
Practice Address - Street 1:1600 4TH AVE N
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35020-5711
Practice Address - Country:US
Practice Address - Phone:205-703-2020
Practice Address - Fax:205-957-6601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2423101YM0800X, 101YP2500X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty