Provider Demographics
NPI:1548792682
Name:MOORE COUNSELING AND CONSULTING SERVICES, LLC.
Entity Type:Organization
Organization Name:MOORE COUNSELING AND CONSULTING SERVICES, LLC.
Other - Org Name:BUILDING BLOCKS FAMILY COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:912-675-8913
Mailing Address - Street 1:205 S SKINNER AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-3221
Mailing Address - Country:US
Mailing Address - Phone:912-349-8043
Mailing Address - Fax:
Practice Address - Street 1:205 S SKINNER AVE UNIT B
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322
Practice Address - Country:US
Practice Address - Phone:912-349-8043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-29
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT001331106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty