Moore, Jennifer Pruitt

Moore, Jennifer Pruitt is an individual health care provider with primary practice located at 524 Signal Hill Drive Ext , Statesville NC 28625-4391. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Moore, Jennifer Pruitt can be contacted via phone (704) 871-1045.

Contact Information

Primary practice address
524 Signal Hill Drive Ext Statesville NC 28625-4391
Phone: (704) 871-1045
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 5257 North Carolina

Profile Details

NPI number 1184631582
LBN Legal business name Moore, Jennifer Pruitt
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2006
Last updated Aug 11th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184631582 NPPES
North Carolina MEDICAID 1184631582
North Carolina MEDICAID 6103396
North Carolina MEDICAID PC1484

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