Individual
PATRICK MICHAEL MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACSW, LCSW
Contact information
Practice address
1700 E 38TH ST, MARION, IN 46953-4568
(765) 674-3321
(765) 677-5115
Mailing address
1700 E 38TH ST, MARION, IN 46953-4568
(765) 674-3321
(765) 677-5115
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
34001741
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000328198
BCBS
IN
Enumeration date
12/22/2006
Last updated
03/27/2013
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