Provider Demographics
NPI:1861057150
Name:MONIQUE MOORE, PLLC
Entity type:Organization
Organization Name:MONIQUE MOORE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:S
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:202-299-0216
Mailing Address - Street 1:3904 INGOMAR ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-1916
Mailing Address - Country:US
Mailing Address - Phone:202-297-9407
Mailing Address - Fax:
Practice Address - Street 1:3000 CONNECTICUT AVE NW STE 137A
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-2683
Practice Address - Country:US
Practice Address - Phone:202-290-0216
Practice Address - Fax:202-299-0216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-02
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty