Provider Demographics
NPI:1194819433
Name:MOORE, GUY MICHAEL (LPC)
Entity Type:Individual
Prefix:
First Name:GUY
Middle Name:MICHAEL
Last Name:MOORE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 PALMER HIGHWAY
Mailing Address - Street 2:SUITE C
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77590
Mailing Address - Country:US
Mailing Address - Phone:409-935-7900
Mailing Address - Fax:409-943-5220
Practice Address - Street 1:2925 PALMER HIGHWAY
Practice Address - Street 2:SUITE C
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77590
Practice Address - Country:US
Practice Address - Phone:409-935-7900
Practice Address - Fax:409-943-5220
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12432101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional