Provider Demographics
NPI:1316279334
Name:ANGELA MOORE COUNSELING LLC
Entity type:Organization
Organization Name:ANGELA MOORE COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:205-365-7699
Mailing Address - Street 1:5484 LITTLETON KILGORE RD
Mailing Address - Street 2:
Mailing Address - City:DORA
Mailing Address - State:AL
Mailing Address - Zip Code:35062
Mailing Address - Country:US
Mailing Address - Phone:205-365-7699
Mailing Address - Fax:205-648-4551
Practice Address - Street 1:2165 HWY 78
Practice Address - Street 2:STE 100
Practice Address - City:DORA
Practice Address - State:AL
Practice Address - Zip Code:35062
Practice Address - Country:US
Practice Address - Phone:205-648-4567
Practice Address - Fax:205-648-4551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-01
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2425251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health