Provider Demographics
NPI:1811765894
Name:RECEIVING MOORE PSYCHOTHERAPY PC
Entity type:Organization
Organization Name:RECEIVING MOORE PSYCHOTHERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:D
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP
Authorized Official - Phone:402-413-1895
Mailing Address - Street 1:6315 AYLESWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68505-1276
Mailing Address - Country:US
Mailing Address - Phone:402-413-1895
Mailing Address - Fax:402-347-0909
Practice Address - Street 1:1240 N 10TH ST STE 2
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-1125
Practice Address - Country:US
Practice Address - Phone:402-413-1895
Practice Address - Fax:402-347-0909
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RECEIVING MOORE PSYCHOTHERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty