SHANNON DAVID MOORE NPI 1710734157

NPI Information

  • NPI: 1710734157
  • Provider Name: SHANNON DAVID MOORE
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 201 BROADWAY ST
    FREDERICK, MD
    ZIP 21701
  • Phone: (240) 801-7799

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NPI Details

Shannon David Moore is an addiction (substance use disorder) counselor in Frederick, MD. Shannon David Moore NPI is 1710734157. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

201 BROADWAY ST
FREDERICK, MD
ZIP 21701-695
Phone: (240) 801-7799

The enumeration date for this NPI number is 5/3/2024 and was last updated on 5/3/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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