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

Mr. Phillip Moore, MALPC-IT, SAC-IT

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1891554317

Mr. Phillip Moore, MALPC-IT, SAC-IT is an Addiction (Substance Use Disorder) Counselor in Milwaukee, Wisconsin. Practices as a sole proprietor. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2024
Specialties on file
2

Practice location Address checks out

11414 W Park Pl Ste 202
Milwaukee, WI 53224-3500
Phone: (920) 204-6668
Show map & directions

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

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 7610-226 (WI)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 20136-130 (WI)

Record details

NPI number1891554317
Entity typeIndividual (Type 1)
GenderMale
Credentials MALPC-IT , SAC-IT
Sole proprietorYes
NPI enumeratedMarch 18, 2024
Last updated in NPPESMarch 18, 2024
Certification dateMarch 17, 2024

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