Active NPI
Karlen Brook Moore, PH.D.
- Psychologist
- Georgetown, TX
National Provider Identifier
1063774446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 36119
- Practice address
- 501 S Austin Ave # 1220
Georgetown, TX 78626-5637 - Phone
- (512) 959-8864
- Fax
- (800) 561-2019
- NPI assigned
- Jun 12, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 20216 | ||
| Psychologist | 103T00000X | 36119 | TX | Primary |
Addresses
Primary practice location
501 S Austin Ave # 1220
Georgetown, TX 78626-5637
Mailing address
PO Box 811
Jarrell, TX 76537-0811
Other practice location 1
9302 E 22nd St
Tucson, AZ 85710-7342
Phone (520) 278-5758
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20216 | Other | PSYPACT APIT |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36119 | TX | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Moore Psychological Services, PLLC | Psychologist | Current | 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 and National Provider Directory roles.
-
- Psychologist
- Clovis, NM
- NPI 1518453521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742947200000",
"number": "1063774446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 811",
"city": "JARRELL",
"state": "TX",
"postal_code": "765370811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 S AUSTIN AVE # 1220",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786265637",
"telephone_number": "512-959-8864",
"fax_number": "800-561-2019"
}
],
"practiceLocations": [
{
"address_1": "9302 E 22nd St",
"address_purpose": "LOCATION",
"city": "Tucson",
"state": "AZ",
"postal_code": "857107342",
"country_code": "US",
"telephone_number": "520-278-5758",
"fax_number": "317-520-8200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOORE",
"first_name": "KARLEN",
"middle_name": "BROOK",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-12",
"last_updated": "2025-03-26",
"certification_date": "2025-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": "20216",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist",
"state": "TX",
"license": "36119",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYPACT APIT",
"identifier": "20216",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Georgetown, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.