Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Derryck Vancurk Moore, LADC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1336381599

Mr. Derryck Vancurk Moore, LADC is an Addiction (Substance Use Disorder) Counselor in Plymouth, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.

Licensed in
MN
In the registry since
2009
What do these letters mean?
LADC — Licensed Alcohol and Drug Counselor
A licensed addiction counsellor.

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Practice location Address checks out

12400 25th Ave N
Plymouth, MN 55441-4008
Phone: (612) 220-8645
Fax: (952) 405-8090
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 301674 (MN)

Record details

NPI number1336381599
Entity typeIndividual (Type 1)
GenderMale
Credentials LADC
Sole proprietorYes
NPI enumeratedApril 1, 2009
Last updated in NPPESApril 1, 2009

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