Moore, Kenneth Steven

Moore, Kenneth Steven is an individual health care provider with primary practice located at 100 Ledgehill Rd , Bennington VT 05201-2273. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Family, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Moore, Kenneth Steven can be contacted via phone (802) 442-5491.

Contact Information

Primary practice address
100 Ledgehill Rd Bennington VT 05201-2273
Phone: (802) 442-5491
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Family 103TF0000X 0970113490 Vermont
Behavioral Health & Social Service Providers / Psychologist 103T00000X

Profile Details

NPI number 1710358445
LBN Legal business name Moore, Kenneth Steven
Credentials MHP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 7th, 2015
Last updated Dec 22nd, 2015 - about 11 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 1710358445 NPPES
Vermont Other 0970113490 BCBS

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