Maria A Moore, ICS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

15431-134 Issued in WI

Practice address

2319 W Capitol Dr
Milwaukee, WI 53206-1919

Phone

(414) 442-2033

Fax

(414) 442-2167

NPI assigned

Aug 19, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Maria A Melendez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1174956635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2319 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532061919",
            "telephone_number": "414-442-2033",
            "fax_number": "414-442-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2319 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532061919",
            "telephone_number": "414-442-2033",
            "fax_number": "414-442-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARIA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "ICS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-19",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15585-132",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15431-134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "MELENDEZ",
            "middle_name": "A",
            "prefix": "MRS.",
            "credential": "CSIT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Keyiana Moore
• Lakesha Marion Moore
• Lawrence M Moore, MD
• Lundria S Moore, LPN
• Maren Brooke Moore
• Monifa Moore
• Nidra Suwan Moore, R.N.
• Patrice Moore, LPC
• Peggy Kay Moore, OT
• Phillip Moore, MA LPC-IT, SAC-IT

• Addiction (Substance Use Disorder) Counselor in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; 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.