Provider Demographics
NPI:1518267988
Name:MOORHOUSE, MICHAEL (CRC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:MOORHOUSE
Suffix:
Gender:M
Credentials:CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 NW 8TH ST
Mailing Address - Street 2:#2
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-1112
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:213 NW 8TH ST
Practice Address - Street 2:#2
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-1112
Practice Address - Country:US
Practice Address - Phone:352-359-2793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL00050160101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor