Active NPI
Micaela Moreno, LPC-A
- Counselor
- San Angelo, TX
National Provider Identifier
1104531953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 90329
- Practice address
- 36 E Twohig Ave Ste 600
San Angelo, TX 76903-6433 - Phone
- (325) 944-2561
- Fax
- (325) 653-4218
- NPI assigned
- Jan 17, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 90329 | TX | Primary |
Addresses
Primary practice location
36 E Twohig Ave Ste 600
San Angelo, TX 76903-6433
Mailing address
36 E Twohig Ave Ste 600
San Angelo, TX 76903-6433
Phone (325) 944-2561
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8.12.22 | Other | TX | ESSENTIALS OF CBT |
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 |
|---|---|---|---|
| 90329 | TX | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673913600000",
"number": "1104531953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 E TWOHIG AVE STE 600",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769036433",
"telephone_number": "325-944-2561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 E TWOHIG AVE STE 600",
"city": "SAN ANGELO",
"state": "TX",
"postal_code": "769036433",
"telephone_number": "325-944-2561",
"fax_number": "325-653-4218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORENO",
"first_name": "MICAELA",
"credential": "LPC-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-17",
"last_updated": "2023-01-17",
"certification_date": "2023-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "90329",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ESSENTIALS OF CBT",
"identifier": "8.12.22",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Angelo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.