Individual provider · Type 1 NPI

Beverly Smith Moore, PhD, LPC, CCMHC

Professional Counselor · Peachtree City, GA

NPI number 1659663086 Active

Practice location

401 Westpark Ct Ste 200
Peachtree City, GA 30269-3572

Call (678) 523-1715 Map

Mailing address

3135 Duke Dr
Fairburn, GA 30213-8302

Specialties and licenses

TaxonomyCodeLicense
Military Health Care Provider 171000000XLPC003014 (GA)
Addiction (Substance Use Disorder) Counselor 101YA0400XLPC003014 (GA)
Counselor 101Y00000XLPC003014 (GA)
Health & Wellness Coach 171400000XLPC003014 (GA)
Mental Health Counselor 101YM0800XLPC003014 (GA)
Marriage & Family Therapist 106H00000XLPC003014 (GA)
Professional Counselor Primary 101YP2500XLPC003014 (GA)
Pastoral Counselor 101YP1600XLPC003014 (GA)

Professional Counselor: Definition to come...

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About NPI 1659663086

Beverly Smith Moore, PhD, LPC, CCMHC's National Provider Identifier is 1659663086, issued on May 3, 2011. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Peachtree City, GA. The record was last updated on Nov 30, 2025.