Yancy Moore, CDP
Counselor, Addiction (Substance Use Disorder) in Aberdeen, WA. Individual provider (NPI-1).
NPI number1982158481
StatusActive
Last updated in NPPESMay 1, 2018
Details
- NPI
- 1982158481
- Entity type
- Individual (NPI-1)
- Name
- Yancy Moore
- Credential
- CDP
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 12, 2016
- Last updated
- May 1, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | CP60186868 | WA | Yes |
Practice location
2700 Simpson AvenueSuite 101
Aberdeen, WA 98520
Phone 360-612-0012 · Fax 360-218-5945
Mailing address
921 14th AvenueLongview, WA 98632
Phone 360-423-0203 · Fax 360-577-0269
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