Kevin Lowery Moore, MA, LPCC, LADC

NPI #1164151163 in Isanti, Minnesota

Provider Information

NPI Number: 1164151163
Entity Type: Individual
Name: Kevin Lowery Moore, MA, LPCC, LADC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Professional
Credential: MA, LPCC, LADC
Enumeration Date: Jun 7, 2022
Last Updated: Jun 7, 2022

Practice Location

Address: 4463 261ST AVE NW
City: Isanti
State: Minnesota
ZIP Code: 55040-4351
Phone: (176) 327-6028

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Professional — Professional	101YP2500X	Primary

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