Provider Demographics
NPI:1235830316
Name:MOORE, NATASHA DANIELLE (LMFT)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:DANIELLE
Last Name:MOORE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13055
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416-0055
Mailing Address - Country:US
Mailing Address - Phone:478-733-6700
Mailing Address - Fax:
Practice Address - Street 1:617 WALDEN LN
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-8413
Practice Address - Country:US
Practice Address - Phone:478-733-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-15
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health