| Moore Psychotherapy Care Llc | |
|
2400 Chestnut St Apt 2810 Philadelphia PA 19103-4325 | |
| (267) 879-4110 | |
| Not Available |
| Full Name | Moore Psychotherapy Care Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2400 Chestnut St Apt 2810, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Mark Anthony Moore (PROPRIETOR) |
| Authorized Official Contact | 2678794110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Moore Psychotherapy Care Llc 2400 Chestnut St Apt 2810 Philadelphia PA 19103-4325 Ph: (267) 879-4110 | Moore Psychotherapy Care Llc 2400 Chestnut St Apt 2810 Philadelphia PA 19103-4325 Ph: (267) 879-4110 |
| NPI Number | 1265856447 |
|---|---|
| Provider Enumeration Date | 02/09/2014 |
| Last Update Date | 02/21/2024 |
| Certification Date | 02/21/2024 |
| Medicare PECOS PAC ID | 4385874254 |
|---|---|
| Medicare Enrollment ID | O20140221000355 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265856447 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PS015627 (Pennsylvania) | Primary |
| Provider Name | Mark A Moore |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669690905 PECOS PAC ID: 7416989751 Enrollment ID: I20050907000734 |
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