Provider Demographics
NPI:1811754427
Name:MOORE, DANIEL (LPC-MHSP)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:MOORE
Suffix:
Gender:M
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3641 GARNERS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-4603
Mailing Address - Country:US
Mailing Address - Phone:615-554-9155
Mailing Address - Fax:
Practice Address - Street 1:1224 COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-3619
Practice Address - Country:US
Practice Address - Phone:615-554-9155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000004938101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional