Provider Demographics
NPI:1992412530
Name:MOORE, CHRISTOPHER (LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:MOORE
Suffix:
Gender:M
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 121835
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-7835
Mailing Address - Country:US
Mailing Address - Phone:855-579-5323
Mailing Address - Fax:855-579-5323
Practice Address - Street 1:1540 SOUTHTOWN DR STE 106
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-2667
Practice Address - Country:US
Practice Address - Phone:855-579-5323
Practice Address - Fax:855-579-5323
Is Sole Proprietor?:No
Enumeration Date:2022-11-02
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81522101YP2500X
TX89400101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional