Provider Demographics
NPI:1497872139
Name:MOORE, HOWARD STEVEN JR (MED, LCPC)
Entity Type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:STEVEN
Last Name:MOORE
Suffix:JR
Gender:M
Credentials:MED, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714-3705
Mailing Address - Country:US
Mailing Address - Phone:406-579-1741
Mailing Address - Fax:
Practice Address - Street 1:206 NORTH BROADWAY ST.
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714
Practice Address - Country:US
Practice Address - Phone:406-579-1741
Practice Address - Fax:406-388-5275
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1146101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional