Provider Demographics
NPI:1659124808
Name:MOORE, ALLEN DEE III (LPCA)
Entity Type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:DEE
Last Name:MOORE
Suffix:III
Gender:M
Credentials:LPCA
Other - Prefix:
Other - First Name:TREY
Other - Middle Name:
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1407 GORDON RD
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-9712
Mailing Address - Country:US
Mailing Address - Phone:803-448-4750
Mailing Address - Fax:
Practice Address - Street 1:1407 GORDON RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-9712
Practice Address - Country:US
Practice Address - Phone:803-448-4750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health