Gennea Nickole Moore, LLP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6351000450 Issued in MI

Practice address

18303 E 10 Mile Rd
Roseville, MI 48066-4988

Phone

(248) 469-9519

NPI assigned

Jan 21, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Richard Kneip, PH.D., P.C.

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  NPD (past)

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

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1043458516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22524 SCHROEDER AVE",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480214010",
            "telephone_number": "248-469-9519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18303 E 10 MILE RD",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664988",
            "telephone_number": "248-469-9519"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22708 Harper Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Clair Shores",
            "state": "MI",
            "postal_code": "480801823",
            "country_code": "US",
            "telephone_number": "586-264-3692",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "GENNEA",
        "middle_name": "NICKOLE",
        "name_prefix": "Ms.",
        "credential": "LLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-21",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301013299",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301013299",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6351000450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory G Montpetit, M.D.
• Michael Joseph Mooney, MA,LLP,CAC,CCS,CCJP
• Andrew William James Moore, DO
• Donald R Moore, M.D.
• Douglas R Moore, D.O.
• Nona Moore
• Courtney Morgott, FNP
• Jessica Jean Morrison
• Shyam Sunder Moudgil, MD
• Muhammad U Alam DO PLLC

• Psychologist in Roseville, MI
• Providers in Roseville, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; 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.