Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. DERRYCK VANCURK MOORE, LADC
Active Sole ProprietorMR. DERRYCK VANCURK MOORE, LADC is a Addiction (Substance Use Disorder) Counselor healthcare provider located in PLYMOUTH, Minnesota. NPI 1336381599 is currently active in the NPPES registry. Verify at CMS.
Addiction (Substance Use Disorder) Counselor · PLYMOUTH, MN
Registration Details
- NPI Number
- 1336381599
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 1, 2009 (17.344421175914 yrs)
- Last Updated
- Apr 1, 2009
- License
-
301674 (MN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
12400 25TH AVE NPLYMOUTH, MN, 554414008Browse MN providers · Browse ZIP 55441
- Phone
- 6122208645
- Fax
- 9524058090
- Primary Specialty
-
Addiction (Substance Use Disorder) Counselor
101YA0400X
Other Addiction (Substance Use Disorder) Counselor Providers in PLYMOUTH, MN
| Name | Credential | NPI |
|---|---|---|
| MRS. CANDIDA AMBER DAVENPORT | LAC, LADC | 1932138765 |
| MRS. DEBRA LYNN WOODS | LADC | 1407033434 |
| MS. PATRICIA OVEDIA HEDIGER | LADC | 1669658696 |
| JENNIFER LYNN VOUGHT | LADC | 1265619225 |
| JESSE INDERLEE | LADC | 1013201961 |
| ANNA C SMITH | MA LADC | 1467746313 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.