Individual
SAMANTHA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2751 WOODDALE BLVD, BATON ROUGE, LA 70805-7567
(225) 460-0509
Mailing address
PO BOX 66558, BATON ROUGE, LA 70896-6558
(225) 460-0509
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
LA
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251S00000X
—
LA
Enumeration date
05/12/2017
Last updated
09/15/2025
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