Provider Demographics
NPI:1952726101
Name:M MOORE ENTERPRISES PC
Entity Type:Organization
Organization Name:M MOORE ENTERPRISES PC
Other - Org Name:M MOORE COUNSELING AND CONSULTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:LADC/MH
Authorized Official - Phone:405-223-0738
Mailing Address - Street 1:5929 N MAY AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-3909
Mailing Address - Country:US
Mailing Address - Phone:405-223-0738
Mailing Address - Fax:405-463-6803
Practice Address - Street 1:5929 N MAY AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-3909
Practice Address - Country:US
Practice Address - Phone:405-223-0738
Practice Address - Fax:405-463-6803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-25
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty