Brandy Moore is a Counselor based in West Frankfort, IL. Brandy Moore practices in Carbondale, IL. The NPI Number for Brandy Moore is 1427667161 and holds a License No. (Illinois).
The current practice location address for Brandy Moore is 200 N Emerald Ln, Carbondale, IL and can be reached out via phone at 618-457-6703.
Location: 200 N Emerald Ln, Carbondale, IL, 62896-2210
Provider Profile Details
NPI Number
1427667161
Provider Name
Brandy Moore
Credential
Provider Entity Type
Individual
Gender
Female
Address
200 N Emerald Ln, Carbondale, IL, 62896-2210
Phone Number
618-457-6703
Fax Number
Provider Enumeration Date
07/29/2020
Last Update Date
03/10/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IL2970 | 05 | IL |
Provider Business Practice Location Address Details
Address
200 N Emerald Ln
City
State
Zip
62901-2159
Phone Number
618-457-6703
Fax Number
Provider Business Mailing Address Details
Address
200 N Emerald Ln
City
State
Zip
62901-2159
Phone Number
618-457-6703
Fax Number
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
License No.
(Illinois)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
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