Moore, Marissa

Moore, Marissa is an individual health care provider with primary practice located at 1925 Hayes Ave , Sandusky OH 44870. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Moore, Marissa can be contacted via phone (419) 557-5177.

Contact Information

Primary practice address
1925 Hayes Ave Sandusky OH 44870
Phone: (419) 557-5177
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X C.1700197 Ohio
Other Service Providers / Case Manager/Care Coordinator 171M00000X CDCA.150752 Ohio
Behavioral Health & Social Service Providers / Professional 101YP2500X E.2001980 Ohio

Profile Details

NPI number 1073027678
LBN Legal business name Moore, Marissa
Credentials LPCC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 20th, 2017
Last updated Dec 14th, 2020 - 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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Identifiers

StateTypeNumberIssuer
All States NPI 1073027678 NPPES
Ohio MEDICAID 3293725

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