Active NPI
Sophia Moore
- Mental Health Counselor
- Raeford, NC
National Provider Identifier
1104094978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- S6959
- Practice address
- 168 Bennington Dr
Raeford, NC 28376-6559 - Phone
- (910) 263-6219
- NPI assigned
- Feb 14, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 232 | SC | |
| Professional Counselor | 101YP2500X | PRC14509 | DC | |
| Professional Counselor | 101YP2500X | 0701006133 | VA | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 24951-A | NC | |
| Mental Health Counselor | 101YM0800X | S6959 | NC | Primary |
Addresses
Primary practice location
168 Bennington Dr
Raeford, NC 28376-6559
Mailing address
168 Bennington Dr
Raeford, NC 28376-6559
Phone (910) 263-6219
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 |
|---|---|---|---|
| 24951-A | NC | MD | Addiction (Substance Use Disorder) Counselor |
| S6959 | NC | MD | Mental Health Counselor |
| PRC14509 | DC | MD | Professional Counselor |
| 232 | SC | MD | Professional Counselor |
| 0701006133 | VA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741305600000",
"number": "1104094978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "168 BENNINGTON DR",
"city": "RAEFORD",
"state": "NC",
"postal_code": "283766559",
"telephone_number": "910-263-6219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "168 BENNINGTON DR",
"city": "RAEFORD",
"state": "NC",
"postal_code": "283766559",
"telephone_number": "910-263-6219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "SOPHIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-14",
"last_updated": "2025-03-07",
"certification_date": "2025-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "SC",
"license": "232",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "DC",
"license": "PRC14509",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701006133",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "24951-A",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "S6959",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raeford, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.