Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Carrie Renae Moore, SAC-IT

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1508684804

Carrie Renae Moore, SAC-IT is an Addiction (Substance Use Disorder) Counselor in Kenosha, Wisconsin. Practices as a sole proprietor. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2024
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Practice location Address checks out

6321 23rd Ave
Kenosha, WI 53143-4805
Phone: (262) 671-1625
Fax: (866) 719-3024
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 20205-130 (WI)

Record details

NPI number1508684804
Entity typeIndividual (Type 1)
GenderFemale
Credentials SAC-IT
Sole proprietorYes
NPI enumeratedSeptember 26, 2024
Last updated in NPPESOctober 29, 2024
Certification dateOctober 29, 2024

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