Individual
JOHN DAVID MOORE II
Active
Individual
JOHN DAVID MOORE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
9119
NC
101YP2500X
Professional Counselor
Primary
1326 LCPC
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000744050
BLUE CROSS-SHIELD PROV #
MT
05
—
1639369556
—
NC
Enumeration date
07/26/2007
Last updated
02/29/2012
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