Moore, Latrease R

Moore, Latrease R is an individual health care provider with primary practice located at 1612 Genesee St , Utica NY 13502-5425. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Moore, Latrease R can be contacted via phone (315) 724-5173.

Contact Information

Primary practice address
1612 Genesee St Utica NY 13502-5425
Phone: (315) 724-5173
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 005071 New York
Behavioral Health & Social Service Providers / Clinical 103TC0700X 024435-01 New York

Profile Details

NPI number 1497114920
LBN Legal business name Moore, Latrease R
Credentials LMHC
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 11th, 2016
Last updated Dec 1st, 2021 - about 5 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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