Courtney Moore
Mental Health Counselor
2055 Garrett Way Ste 2
Pocatello
, Idaho 83201-5100
Courtney Moore
Mental Health Counselor
2055 Garrett Way Ste 2
Pocatello
, Idaho 83201-5100
(208) 236-1600
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About
Features
Specialties
- Mental Health Counselor
Languages spoken
- English
Location
First Address
- Courtney Moore
- Po Box 4908
- Pocatello, ID
- Zip : 83205-4908
- Phone : (208) 236-1600
Second Address
- Courtney Moore
- 2055 Garrett Way Ste 2
- Pocatello, ID
- Zip : 83201-5100
- Phone : (208) 233-7832
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 101YM0800X | Mental Health Counselor |
National Provider Identifier
| NPI | 1003178559 |
|---|---|
| Provider Name | Courtney Moore |
| First Address | Pocatello, ID 83205-4908 |
| Second Address | Pocatello, ID 83201-5100 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/06/2012 |
| Last Update Date | 11/06/2012 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.