Individual provider · Type 1 NPI

Evan Moore

Mental Health Counselor · Peoria, IL

NPI number 1407734668 Active

Practice location

6615 N Big Hollow Rd
Peoria, IL 61615-2450

Fax (309) 692-6952

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1407734668

Evan Moore's National Provider Identifier is 1407734668, issued on Aug 25, 2025. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Peoria, IL. The record was last updated on Aug 25, 2025.