Michael David Moore | Valparaiso, IN • PECOS Search

Michael David Moore

Counselor

Behavioral Health & Social Service Providers

601 Wall St, Valparaiso, IN 46383-2512

PECOS Enrollment

Based on the most recent information from CMS, provider Michael David Moore does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1881241412
Provider Type
Individual
Full Name
Moore, Michael David
Credential
LMHC, NCC

Gender
Male
Sole Proprietor
Yes
Enumeration Date
8/19/2019
Last Updated
2/10/2022

Contact Information

Practice Location

601 Wall St, Valparaiso, IN 46383-2512

Unlisted Fax

Mailing Location

601 Wall St, Valparaiso, IN 46383-2512

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License 39004083A Indiana