Timothy Howard Moore, L.P.C.

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

3040 N University Ave
Suite 2
Decatur, IL 62526-1391

Phone

(217) 872-1700

Fax

(217) 872-1366

NPI assigned

Apr 14, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Mental Health Counselor

Education

Other, 2007

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Decatur Counseling Center, LLC

  • Clinical Social Worker
  • Decatur, IL
  • NPI 1548136583
  NPD
• Decatur Psychological Associates PC

  • Counselor
  • Decatur, IL
  • NPI 1184732745
  NPD

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208131200000",
    "number": "1144494881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 N UNIVERSITY AVE",
            "address_2": "SUITE 2",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625261391",
            "telephone_number": "217-872-1700",
            "fax_number": "217-872-1366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 N UNIVERSITY AVE",
            "address_2": "SUITE 2",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625261391",
            "telephone_number": "217-872-1700",
            "fax_number": "217-872-1366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TIMOTHY",
        "middle_name": "HOWARD",
        "name_prefix": "Mr.",
        "credential": "L.P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-14",
        "last_updated": "2008-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Moore, DMD
• Emma Moore
• Mark J Moore Jr., MD
• Renata Charissa Moore, M.D.
• Terance Moore, PHARMD
• Adills Moosa, DO
• Edna S Morgan
• David R Morgret, O.D.
• Vidya Sagar Rao Morisetty, MD
• Julia Catherine Moroney

• Counselor in Decatur, IL
• Providers in Decatur, IL by specialty
• Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; 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.