Charlotte A Moore, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2010032196 Issued in MO

Practice address

104 Crescent Dr
Lebanon, MO 65536-3301

Phone

(417) 588-5885

Fax

(417) 588-4296

NPI assigned

Sep 14, 2010

Last updated

Jul 30, 2025By the provider in NPPES

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

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1073821963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 CRESCENT DR",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655363301",
            "telephone_number": "417-588-5885",
            "fax_number": "417-588-4296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 CRESCENT DR",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655363301",
            "telephone_number": "417-588-5885",
            "fax_number": "417-588-4296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHARLOTTE",
        "middle_name": "A",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-14",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2010032196",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2010032196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nakkia Danielle Miller, LPN
• Missouri Behavioral Health Counseling Associates
• Julie Mitchell, LPC
• Philip V. Mitchell, MD
• Michael R Montgomery, OD
• Morgan Moore, DC
• Ronna Ann Moore, PTA
• Donna Jean Moriarty, RNC, WHNP
• Abigail Nicole Motsinger
• Katera Mowry, PLP

• Professional Counselor in Lebanon, MO
• Providers in Lebanon, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.