Individual
DR. BEVERLY SMITH MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LPC, CCMHC
Contact information
Practice address
401 WESTPARK CT STE 200, PEACHTREE CITY, GA 30269-3572
(678) 523-1715
Mailing address
3135 DUKE DR, FAIRBURN, GA 30213-8302
(678) 523-1715
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC003014
GA
101YA0400X
Addiction (Substance Use Disorder) Counselor
LPC003014
GA
101YM0800X
Mental Health Counselor
LPC003014
GA
101YP1600X
Pastoral Counselor
LPC003014
GA
101YP2500X
Professional Counselor
Primary
LPC003014
GA
106H00000X
Marriage & Family Therapist
LPC003014
GA
171000000X
Military Health Care Provider
LPC003014
GA
171400000X
Health & Wellness Coach
LPC003014
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003109153A
—
GA
Enumeration date
05/03/2011
Last updated
11/30/2025
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