Individual
DR. THERESA DENISE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D., LCPC
Contact information
Practice address
567 W CHANNEL ISLANDS BLVD # 203, PORT HUENEME, CA 93041-2133
(480) 512-9500
Mailing address
567 W CHANNEL ISLANDS BLVD # 203, PORT HUENEME, CA 93041-2133
(480) 512-9500
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
178.007134
IL
101YM0800X
Mental Health Counselor
Primary
LPC20270
AZ
101YM0800X
Mental Health Counselor
PC6401019591
MI
101YP2500X
Professional Counselor
178.007134
IL
101YP2500X
Professional Counselor
Primary
LPC20270
AZ
Other
Enumeration date
07/05/2013
Last updated
04/27/2026
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