Provider Demographics
NPI:1679714380
Name:MOORE, LAURA JOSIE (LPC, NBCC, PHD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:JOSIE
Last Name:MOORE
Suffix:
Gender:F
Credentials:LPC, NBCC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-5236
Mailing Address - Country:US
Mailing Address - Phone:717-875-4217
Mailing Address - Fax:717-393-9990
Practice Address - Street 1:313 W LIBERTY ST STE 222
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-2766
Practice Address - Country:US
Practice Address - Phone:178-754-2177
Practice Address - Fax:717-393-9990
Is Sole Proprietor?:No
Enumeration Date:2009-03-11
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003033101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional