Lisa Beth Moore
Professional Counselor
101 W Broadway Fl 2
Waukesha
, Wisconsin 53186-4833
Lisa Beth Moore
Professional Counselor
101 W Broadway Fl 2
Waukesha
, Wisconsin 53186-4833
(262) 364-4968
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About
Features
Specialties
- Professional Counselor
Languages spoken
- English
Location
First Address
- Lisa Beth Moore
- Po Box 1298
- Woodruff, WI
- Zip : 54568-1298
- Phone : (262) 364-4968
Second Address
- Lisa Beth Moore
- 101 W Broadway Fl 2
- Waukesha, WI
- Zip : 53186-4833
- Phone : (262) 547-5567
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 101YP2500X | Professional Counselor | 3523-266 | WI |
National Provider Identifier
| NPI | 1003470303 |
|---|---|
| Provider Name | Lisa Beth Moore |
| First Address | Woodruff, WI 54568-1298 |
| Second Address | Waukesha, WI 53186-4833 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/04/2019 |
| Last Update Date | 23/04/2019 |
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.