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MR. PHILLIP MOORE MA LPC-IT, SAC-IT
NPI 1891554317
Counselor - Professional in Milwaukee, WI

Active since March 18, 2024
11414 W PARK PL STE 202, MILWAUKEE, WI 53224(920) 204-6668 Get Directions Write a Review

NPPES record last updated: March 18, 2024. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Mr. Phillip Moore Ma Lpc-it, Sac-it NPPES

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

MR. PHILLIP MOORE MA LPC-IT, SAC-IT (NPI 1891554317) is an individual professional provider in Milwaukee, Wisconsin, licensed in Wisconsin (7610-226) and active in the NPI registry since March 2024.

NPPES Registry Identity

NPI1891554317
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMR. PHILLIP MOORECredential: MA LPC-IT, SAC-IT
Location Address11414 W PARK PL STE 202Milwaukee, WI 53224-3500
Mailing Address11414 W Park Pl Ste 202Milwaukee, WI 53224-3500 · (920) 204-6668
Phone(920) 204-6668
Sole ProprietorYes
Enumeration DateMarch 18, 2024
NPPES CertifiedMarch 17, 2024
✔ NPI 1891554317 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in WI · 7610-226
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 20136-130 (WI)
11414 W PARK PL STE 202, Milwaukee, WI 53224
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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.

PERRY HENNESSY APNP
Nurse Practitioner (Psychiatric/Mental Health)
11414 W PARK PL STE 202
MILWAUKEE, WI 53224
Milwaukee County (877) 906-9699
PRESS RESET LLC
Counselor (Professional)
11414 W PARK PL STE 202
MILWAUKEE, WI 53224
Milwaukee County (414) 533-7578
DIANA BASLER HIS
Hearing Instrument Specialist
11414 W PARK PL STE 202
MILWAUKEE, WI 53224
Milwaukee County (920) 399-2081
WIC PRENATAL SERVICES LLC
Case Management
11414 W PARK PL STE 202
MILWAUKEE, WI 53224
Milwaukee County (414) 839-2691
BERGER AND BURROW ENTERPRISES, INC
Physiological Laboratory
11414 W PARK PL STE 202
MILWAUKEE, WI 53224
Milwaukee County (866) 483-9729
ABG WELLNESS GROUP INC
Community/Behavioral Health
11414 W PARK PL STE 202
MILWAUKEE, WI 53224
Milwaukee County (414) 292-7060
SENIORWELL OF WISCONSIN LLC
Dentist
11414 W PARK PL STE 202
MILWAUKEE, WI 53224
Milwaukee County (844) 882-3127
DYRESHA WHITESIDE REGISTERED NURSE
Registered Nurse (Home Health)
11414 W PARK PL STE 202
MILWAUKEE, WI 53224
Milwaukee County (414) 716-6257

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 Phillip Moore's NPI number?

The NPI number for Phillip Moore is 1891554317. It was assigned to this individual provider in the NPPES registry on March 18, 2024.

Where is Phillip Moore located?

Phillip Moore practices at 11414 W Park Pl Ste 202, Milwaukee, WI 53224. The listed phone number is (920) 204-6668.

What is Phillip Moore's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Phillip Moore was last updated on March 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.