Individual provider Active NPI

Heather Helen Moore, LPC

  • Professional Counselor
  • Allentown, PA
National Provider Identifier
1104434919
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC012525 Issued in PA
Practice address
3080 Hamilton Blvd Ste 200
Allentown, PA 18103-3692
Phone
(484) 661-4642
Fax
(484) 661-4644
NPI assigned
Jul 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X PC012525 PA Primary

Addresses

Primary practice location

3080 Hamilton Blvd Ste 200
Allentown, PA 18103-3692

Mailing address

2100 Mack Blvd FL 4
Allentown, PA 18103-5622
Phone (484) 884-4500

Other practice location 1

1650 Broadway Fl 2
Bethlehem, PA 18015-3998
Phone (484) 274-7541

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address heather.moore@kidspeace.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20240627002726 PA Practitioner - Mental Health Counselor 2567906886 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Apr 11, 2024 Accepting new patients
Lehigh Valley Physician Group Single Specialty CurrentSince Apr 11, 2024 Accepting new patients
Lehigh Valley Physician Group Single Specialty Current Accepting new patients
West End Counseling & Wellness, LLC Professional Past Accepting new patients

Locations

3080 Hamilton Blvd
Ste 200
Allentown, PA 18103
Phone (484) 661-4641

2100 Mack Blvd
Fl 4
Allentown, PA 18103

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1594944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1104434919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 4",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "484-884-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 HAMILTON BLVD STE 200",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181033692",
            "telephone_number": "484-661-4642",
            "fax_number": "484-661-4644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Broadway Fl 2",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180153998",
            "country_code": "US",
            "telephone_number": "484-274-7541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "HEATHER",
        "middle_name": "HELEN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-17",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC012525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "heather.moore@kidspeace.org",
            "affiliation": "N",
            "endpointDescription": "work email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email address",
            "address_1": "1650 Broadway Fl 2",
            "city": "Bethlehem",
            "state": "PA",
            "country_code": "US",
            "postal_code": "180153998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.