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BRENDA MOORE
NPI 1548787765
Counselor - Addiction (Substance Use Disorder) in Kelso, WA

Active since August 28, 2017
305 PACIFIC AVE S STE 102, KELSO, WA 98626(360) 577-7442(360) 577-7904 Get Directions Write a Review

NPPES record last updated: November 21, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 21, 2019, May 1, 2018, Aug 28, 2017 (3 updates tracked since 2017).

About Brenda Moore NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRENDA MOORE (NPI 1548787765) is an individual addiction (substance use disorder) provider in Kelso, Washington, licensed in Washington (CP00002285) and active in the NPI registry since August 2017.

NPPES Registry Identity

NPI1548787765
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameBRENDA MOORE
Location Address305 PACIFIC AVE S STE 102Kelso, WA 98626-1638
Mailing AddressPo Box 1847Longview, WA 98632-8140 · (360) 423-0203 · Fax (360) 577-0269
Phone(360) 577-7442
Fax(360) 577-7904
Sole ProprietorNo
Enumeration DateAugust 28, 2017
Last NPPES UpdateNovember 21, 20193 updates tracked since enumeration
✔ NPI 1548787765 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in WA · CP00002285
305 PACIFIC AVE S STE 102, Kelso, WA 98626
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Other Identifiers 1

Medicaid2101460WA

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ARIEL JONES
Counselor (Addiction (Substance Use Disorder))
305 PACIFIC AVE S STE 102
KELSO, WA 98626
Cowlitz County (360) 577-7442
SAVANNAH E ANDREWS
Student in an Organized Health Care Education/Training Program
305 PACIFIC AVE S STE 102
KELSO, WA 98626
Cowlitz County (360) 423-0203
KENNETH CASE CDPT
Counselor (Addiction (Substance Use Disorder))
305 PACIFIC AVE S STE 102
KELSO, WA 98626
Cowlitz County (360) 577-7442
CATHY LUDAHL CDP
Counselor (Addiction (Substance Use Disorder))
305 PACIFIC AVE S STE 102
KELSO, WA 98626
Cowlitz County (360) 577-7442
CRYSTAL WINK
Student in an Organized Health Care Education/Training Program
305 PACIFIC AVE S STE 102
KELSO, WA 98626
Cowlitz County (360) 423-0203
MR. PAUL TRAVIS KERN CDAC
Counselor (Addiction (Substance Use Disorder))
305 PACIFIC AVE S STE 102
KELSO, WA 98626
Cowlitz County (360) 577-7442
MR. JAMES ANTHONY LAPORTA CDPT
Counselor (Addiction (Substance Use Disorder))
305 PACIFIC AVE S STE 102
KELSO, WA 98626
Cowlitz County (360) 577-7442
TAMARA HARTGROVE SUDP
Counselor (Addiction (Substance Use Disorder))
305 PACIFIC AVE S STE 102
KELSO, WA 98626
Cowlitz County (360) 423-0203

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brenda Moore's NPI number?

The NPI number for Brenda Moore is 1548787765. It was assigned to this individual provider in the NPPES registry on August 28, 2017.

Where is Brenda Moore located?

Brenda Moore practices at 305 Pacific Ave S Ste 102, Kelso, WA 98626. The listed phone number is (360) 577-7442.

What is Brenda Moore's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Brenda Moore was last updated on November 21, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.