Provider Demographics
NPI:1821665217
Name:MOORE'S COUNSELING & CONSULTATION SERVICES, LLC
Entity Type:Organization
Organization Name:MOORE'S COUNSELING & CONSULTATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAUNTAE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S, NCC, BC-TMH,
Authorized Official - Phone:225-283-1205
Mailing Address - Street 1:23190 ARCWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-2323
Mailing Address - Country:US
Mailing Address - Phone:504-214-4490
Mailing Address - Fax:
Practice Address - Street 1:23190 ARCWOOD DR
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-2323
Practice Address - Country:US
Practice Address - Phone:504-214-4490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-05
Last Update Date:2021-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1548636475Medicaid