IndividualActive
Jacob Moore, PH.D.
NPI 1821762220 · Counseling Psychologist · Rockville, MD
Provider details
- NPI number
- 1821762220
- Entity type
- Individual
- Primary specialty
- Counseling PsychologistBehavioral Health & Social Service Providers
- Credential
- PH.D.
- Sex
- Male
- Sole proprietor
- No
- License
- A0611 (MD)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Practice location
9707 Key West Ave Ste 100
Rockville, MD 20850-3992
Phone: (240) 750-6467
Approximate (ZIP-level) locationGet directions
Mailing address
5822 Barnwood Pl
Columbia, MD 21044-2842
Registry dates
- Enumerated
- 2021-08-09
- Last updated
- 2025-03-07
- Certified
- 2025-03-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.