Provider Demographics
NPI:1275078180
Name:MOORE, FELICIA (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:FELICIA
Middle Name:
Last Name:MOORE
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2654 RIEGEL ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-3449
Mailing Address - Country:US
Mailing Address - Phone:610-601-5950
Mailing Address - Fax:610-601-5930
Practice Address - Street 1:1733 WASHINGTON BLVD STE 108
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042
Practice Address - Country:US
Practice Address - Phone:610-601-5950
Practice Address - Fax:610-601-5930
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-01
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009299101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional