| Mr Derryck Vancurk Moore, LADC | |
|
12400 25th Ave N, Plymouth, MN 55441-4008 | |
| (612) 220-8645 | |
| (952) 405-8090 |
| Full Name | Mr Derryck Vancurk Moore |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 12400 25th Ave N, Plymouth, Minnesota |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336381599 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 301674 (Minnesota) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Derryck Vancurk Moore, LADC 12400 25th Ave N, Plymouth, MN 55441-4008 Ph: (612) 220-8645 | Mr Derryck Vancurk Moore, LADC 12400 25th Ave N, Plymouth, MN 55441-4008 Ph: (612) 220-8645 |
Jesse Inderlee, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 13895 Industrial Park Blvd, Plymouth, MN 55441 Phone: 763-559-5677 | |
Lauris J Prinsen, L.A.D.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 12805 Highway 55, Suite 211, Plymouth, MN 55441 Phone: 763-550-9005 Fax: 763-559-2118 | |
Jessica Sklar, MA, LPCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 19095 51st Pl N, Plymouth, MN 55446 Phone: 952-212-1330 | |
Luke Morken, Counselor Medicare: Not Enrolled in Medicare Practice Location: 10000 Hwy 55 Ste 300, Plymouth, MN 55441 Phone: 763-412-0722 | |
Emily Cross, MA, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 115 Forestview Ln N, Plymouth, MN 55441 Phone: 763-546-8008 | |
Mrs. Melody Joy Richards, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 13210 45th Ave North, Plymouth, MN 55442 Phone: 612-616-0224 Fax: 612-616-0224 | |
Sada Kathryn Puckett, LPCC, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2415 Annapolis Ln N Ste 130, Plymouth, MN 55441 Phone: 763-220-0218 |