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Kenetra Devonne Moore, LCMHC,LCAS,CCS
Addiction (Substance Use Disorder) Counselor in Charlotte, North Carolina
NPI 1407263593

Kenetra Devonne Moore is an Addiction (Substance Use Disorder) Counselor based in Charlotte, NC and is specialized in Addiction (Substance Use Disorder). Kenetra Devonne Moore practices in Charlotte, NC and has the professional credentials of LCMHC,LCAS,CCS. The NPI Number for Kenetra Devonne Moore is 1407263593 and holds a License No. (North Carolina).

The current practice location address for Kenetra Devonne Moore is 1900 Randolph Rd Ste 800, Charlotte, NC and can be reached out via phone at 704-384-1246 and via fax at 704-384-6072.

Location: 1900 Randolph Rd Ste 800, Charlotte, NC, 28260-0447
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Provider Profile Details
NPI Number
1407263593
Provider Name
Kenetra Devonne Moore
Credential
LCMHC,LCAS,CCS
Provider Entity Type
Individual
Gender
Female
Address
1900 Randolph Rd Ste 800, Charlotte, NC, 28260-0447
Phone Number
704-384-1246
Fax Number
704-384-6072
Provider Enumeration Date
07/21/2014
Last Update Date
05/18/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
21286 05 NC
institution
Provider Business Practice Location Address Details
Address
1900 Randolph Rd Ste 800
City
State
Zip
28207-1110
Phone Number
704-384-1246
Fax Number
704-384-6072
person
Provider Business Mailing Address Details
Address
1900 Randolph Rd Ste 800
City
State
Zip
28207-1110
Phone Number
704-384-1246
Fax Number
704-384-6072
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
15759 (North Carolina)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
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