Shawna Donise Moore, PSYD, LPC, BCBA

Primary specialty

CounselorTaxonomy code 101Y00000X

License

4885 Issued in OK

Practice address

614 S Main St
Stillwater, OK 74074-4059

Phone

(405) 824-3408

Fax

(405) 564-0062

NPI assigned

Apr 12, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bison Behavioral

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Stillwater, OK
  • NPI 1669272100
  NPD Authorized official
• Bison Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Stillwater, OK
  • NPI 1629878178
  NPD Authorized official
• Counseling and Behavioral Specialists of Oklahoma

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Stillwater, OK
  • NPI 1760975999
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1302566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1033409099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2118 N MANNING ST",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740752950",
            "telephone_number": "405-824-3408",
            "fax_number": "405-564-0062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 S MAIN ST",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740744059",
            "telephone_number": "405-824-3408",
            "fax_number": "405-564-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SHAWNA",
        "middle_name": "DONISE",
        "credential": "PSYD, LPC, BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-12",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "OK",
            "license": "1-15017996",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": "4885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Lynn Moore
• Jill Ann Moore, MS, RD
• Lloyd B. Moore, MD
• Megan S Moore
• Robert L Moore, DDS
• Shayna Marie Moore
• Anngela Danette Moreno, BS
• Brandee Suzanne Morgan
• Irene J Morgan, BSSW
• Martha Morgan, PHD

• Counselor in Stillwater, OK
• Providers in Stillwater, OK by specialty
• Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.