Provider Demographics
NPI:1396624508
Name:MOORE COUNSELING & WELLNESS LLC
Entity type:Organization
Organization Name:MOORE COUNSELING & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIOBHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:LADC, LCSW
Authorized Official - Phone:207-418-4101
Mailing Address - Street 1:23 ROCK-O-DUNDEE DRIVE
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04270-2973
Mailing Address - Country:US
Mailing Address - Phone:207-418-4101
Mailing Address - Fax:
Practice Address - Street 1:17 GARY ST
Practice Address - Street 2:
Practice Address - City:SOUTH PARIS
Practice Address - State:ME
Practice Address - Zip Code:04281-1636
Practice Address - Country:US
Practice Address - Phone:207-418-4101
Practice Address - Fax:617-802-5561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-01
Last Update Date:2025-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty