Charles N Moore Jr., D.MIN.

Primary specialty

Family PsychologistTaxonomy code 103TF0000X

License

2097 Issued in MA

Practice address

23 Spring St
Essex, MA 01929-1311

Phone

(978) 884-8641

NPI assigned

Dec 14, 2006

Last updated

Sep 11, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Clinical Psychologist

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Supportive Behavioral Care of Ma LLCGroup PAC ID 8628346731, 103 clinicians

Supportive Behavioral Care of Mass LLCGroup PAC ID 8123530169, 49 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Supportive Behavioral Care of Ma LLC

  • Clinical Psychologist
  • Needham, MA
  • NPI 1780115519
  Medicare reassignment Care Compare group NPD
• Supportive Behavioral Care of Mass LLC

  • Psychologist
  • Stoneham, MA
  • NPI 1932914223
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1104988500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 SPRING ST",
            "city": "ESSEX",
            "state": "MA",
            "postal_code": "019291311",
            "telephone_number": "978-884-8641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 SPRING ST",
            "city": "ESSEX",
            "state": "MA",
            "postal_code": "019291311",
            "telephone_number": "978-884-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHARLES",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.MIN.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "2097",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "2097",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "MA",
            "license": "2097",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "MA",
            "license": "2097",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marnie Lawler, NUTRITION THERAPY PR
• Shayda Majidi-Ahi, PH.D.
• April Dawn Manganiello, M.S.
• James A. Manganiello, EDD.
• Deborah S Mindnich, RNCS
• Christopher M Nadai
• Christiana Elizabeth Ostrowski, LCSW
• Mackenzie Holly Poulos, BCBA
• Kathleen A Quill, BCBA-D
• Anna Rich

• Family Psychologist in Essex, MA
• Providers in Essex, MA by specialty
• Family Psychologist in Massachusetts

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.