| Kevin Moore Counseling, Llc | |
|
313 S 3rd St Goshen IN 46526-3709 | |
| (574) 529-5090 | |
| Not Available |
| Full Name | Kevin Moore Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 313 S 3rd St, Goshen, Indiana |
| Authorized Official Name and Position | Kevin L Moore (THERAPIST) |
| Authorized Official Contact | 5745295090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Moore Counseling, Llc Po Box 761 North Webster IN 46555-0761 Ph: (574) 529-5090 | Kevin Moore Counseling, Llc 313 S 3rd St Goshen IN 46526-3709 Ph: (574) 529-5090 |
| NPI Number | 1154827129 |
|---|---|
| Provider Enumeration Date | 03/30/2018 |
| Last Update Date | 03/30/2018 |
| Medicare PECOS PAC ID | 9739444225 |
|---|---|
| Medicare Enrollment ID | O20180605000044 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154827129 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 34005489A (Indiana) | Primary |
| Provider Name | Kevin L Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154452910 PECOS PAC ID: 6103997515 Enrollment ID: I20080612000257 |
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