Provider Demographics
NPI:1255765517
Name:MOORE, ARIEL CHRISTINA (LPC-S)
Entity type:Individual
Prefix:MS
First Name:ARIEL
Middle Name:CHRISTINA
Last Name:MOORE
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:MRS
Other - First Name:ARIEL
Other - Middle Name:CHRISTINA
Other - Last Name:FERGUSON-KIRKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC-S
Mailing Address - Street 1:1002 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-4143
Mailing Address - Country:US
Mailing Address - Phone:318-222-6226
Mailing Address - Fax:318-524-7252
Practice Address - Street 1:1002 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4143
Practice Address - Country:US
Practice Address - Phone:318-222-6226
Practice Address - Fax:318-524-7252
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-22
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5076101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional