# NICHOLAUS OWEN MOORE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1649914409
- **Gender:** Man
- **Credential:** CMHC, MA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 12735586-6009 | UT | Yes |
| 101YM0800X | Mental Health Counselor | 14218391-6004 | NULL | Yes |

## Other

- **Enumeration date:** 04/26/2022
- **Last updated:** 07/02/2026