Lisa J Moore LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

LISA J MOORE LLC

Practice address

1409 Kingsley Ave Ste 9D
Orange Park, FL 32073-4580

Phone

(904) 571-8701

Fax

(904) 571-8701

NPI assigned

Apr 30, 2024

Organization subpart

No

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

Authorized official

Name

Elisabeth J Tudor, LMHCNPI 1881659183

Title

Owner

Phone

(904) 269-2931

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elisabeth J Tudor, LMHC

  • Mental Health Counselor
  • Orange Park, FL
  • NPI 1881659183
  NPD Authorized official

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

{
    "created_epoch": "1714435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1093561987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 KINGSLEY AVE STE 9D",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734580",
            "telephone_number": "904-571-8701",
            "fax_number": "904-571-8701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 KINGSLEY AVE STE 9D",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734580",
            "telephone_number": "904-571-8701",
            "fax_number": "904-571-8701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA J MOORE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-30",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "TUDOR",
        "authorized_official_first_name": "ELISABETH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-269-2931",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay J Lindsey, MD
• Diane Linn
• Philip Todd Linsky, DO
• Lionel J Gatien DO PA
• Julia Lipkin, DMD
• Kenneth Lisicki, PTA
• Sydney Little
• Liv Specialty Care FL, PA
• Live Well Medical Services, LLC
• Pamela D Lively, BCBA

• Mental Health Counselor in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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.