Provider Demographics
NPI:1578733796
Name:MOORE, JANET (LMHC, CHT)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:
Last Name:MOORE
Suffix:
Gender:F
Credentials:LMHC, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 NW 37TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-2042
Mailing Address - Country:US
Mailing Address - Phone:352-373-8047
Mailing Address - Fax:
Practice Address - Street 1:3221 NW 13TH ST
Practice Address - Street 2:SUITE C-2
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-5903
Practice Address - Country:US
Practice Address - Phone:352-339-5085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0001764101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health