Provider Demographics
NPI:1588022206
Name:MOORE COUNSELING SERVICES
Entity Type:Organization
Organization Name:MOORE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:JILL
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:NCC, LPC, QMHP
Authorized Official - Phone:605-651-2340
Mailing Address - Street 1:808 NW 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:SD
Mailing Address - Zip Code:57042-2518
Mailing Address - Country:US
Mailing Address - Phone:605-651-2340
Mailing Address - Fax:
Practice Address - Street 1:808 NW 3RD ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:SD
Practice Address - Zip Code:57042-2518
Practice Address - Country:US
Practice Address - Phone:605-651-2340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD27462251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health