Pediatric & Family Psychology Center PA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1 Issued in MN

Legal business name

PEDIATRIC & FAMILY PSYCHOLOGY CENTER PA

Doing business as

CH Moore PhD dba Pediatric & Family Psychology Center PA

Practice address

2440 N Charles Street
Suite 236
North Saint Paul, MN 55109-3050

Phone

(651) 771-4766

Fax

(651) 771-4784

NPI assigned

Jul 28, 2005

Organization subpart

No

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

Authorized official

Name

Dr. C L Moore, PHDNPI 1982737011

Title

Owner

Phone

(651) 771-4766

Specialties & licenses 4

Addresses

Other identifiers 5

Other names 1

• CH Moore PhD dba Pediatric & Family Psychology Center PA Doing business as

Locations

Practitioners 1

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

• C L Moore, PHD LP LMFT

  • Marriage & Family Therapist
  • N St Paul, MN
  • NPI 1982737011

  Psychologist

  NPD (past) Authorized official

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1104826510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 N CHARLES STREET",
            "address_2": "SUITE 236",
            "city": "NORTH SAINT PAUL",
            "state": "MN",
            "postal_code": "551093050",
            "telephone_number": "651-771-4766",
            "fax_number": "651-771-4784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 N CHARLES STREET",
            "address_2": "SUITE 236",
            "city": "NORTH SAINT PAUL",
            "state": "MN",
            "postal_code": "551093050",
            "telephone_number": "651-771-4766",
            "fax_number": "651-771-4784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC & FAMILY PSYCHOLOGY CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-28",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "C",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-771-4766",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP2246",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY00000625",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "CO",
            "license": "440",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MN",
            "identifier": "6049644",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PART NERS",
            "identifier": "HP19293",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39036800",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "104097",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS/BT",
            "identifier": "212T8PE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CH Moore PhD dba Pediatric & Family Psychology Center PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Marriage & Family Therapist in North Saint Paul, MN
• Providers in North Saint Paul, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.

Verify at the official NPI Registry.