Provider Demographics
NPI:1366638264
Name:MOORE COUNSELING SERVICES, INC.
Entity Type:Organization
Organization Name:MOORE COUNSELING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENEE'
Authorized Official - Middle Name:D
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:517-320-5657
Mailing Address - Street 1:1815 GRAYS LAKE RD
Mailing Address - Street 2:
Mailing Address - City:JONESVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49250-9764
Mailing Address - Country:US
Mailing Address - Phone:517-320-5657
Mailing Address - Fax:517-278-8901
Practice Address - Street 1:259 E CHICAGO ST
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-2046
Practice Address - Country:US
Practice Address - Phone:517-320-5657
Practice Address - Fax:517-278-8901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801086022251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health