Active NPI
Shauna K Moore, LMFT
- Addiction (Substance Use Disorder) Counselor
- Sanford, NC
National Provider Identifier
1033440219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 22993
- Practice address
- 130 Carbonton Rd
Sanford, NC 27330-4009 - Phone
- (919) 774-6522
- NPI assigned
- Jan 27, 2010
- Last updated
- Sep 18, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 22993 | NC | Primary |
| Marriage & Family Therapist | 106H00000X | 1645 | NC |
Addresses
Primary practice location
130 Carbonton Rd
Sanford, NC 27330-4009
Mailing address
284 Executive Park Dr Ste 100
Concord, NC 28025-1833
Phone (704) 939-1110
Other practice location 1
3205 US 421 N
Lillington, NC 27546-7428
Phone (317) 902-8471
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1645 | NC | MD | Clinical Psychologist |
| 22993 | NC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seasons Change, PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Lillington, NC
- NPI 1700937190
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568764800000",
"number": "1033440219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "284 EXECUTIVE PARK DR STE 100",
"city": "CONCORD",
"state": "NC",
"postal_code": "280251833",
"telephone_number": "704-939-1110",
"fax_number": "704-939-1173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 CARBONTON RD",
"city": "SANFORD",
"state": "NC",
"postal_code": "273304009",
"telephone_number": "919-774-6522"
}
],
"practiceLocations": [
{
"address_1": "3205 US 421 N",
"address_purpose": "LOCATION",
"city": "Lillington",
"state": "NC",
"postal_code": "275467428",
"country_code": "US",
"telephone_number": "317-902-8471",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOORE",
"first_name": "SHAUNA",
"middle_name": "K",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-27",
"last_updated": "2019-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "22993",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NC",
"license": "1645",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sanford, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.