Provider Demographics
NPI:1861626459
Name:MOORE, AMY M (LMHC)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:M
Last Name:MOORE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3753 VICTORIA DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-4708
Mailing Address - Country:US
Mailing Address - Phone:561-281-0287
Mailing Address - Fax:561-434-4682
Practice Address - Street 1:1402 ROYAL PALM BEACH BLVD
Practice Address - Street 2:SUITE 400B
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1691
Practice Address - Country:US
Practice Address - Phone:561-792-9242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9869101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health