Shirlee Buchanan Moore Jr., DTLLP

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

6352000466 Issued in MI

Practice address

5985 W Main St Ste 101
Kalamazoo, MI 49009-8708

Phone

(269) 459-1818

NPI assigned

Feb 20, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Meredith Psychological and Testing Services, LLC

  • Clinical Psychologist
  • Kalamazoo, MI
  • NPI 1558735266
  NPD (past)

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

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1184124638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16782 VON KARMAN AVE STE 11",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926062417",
            "telephone_number": "855-223-7123",
            "fax_number": "619-374-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5985 W MAIN ST STE 101",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490098708",
            "telephone_number": "269-459-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SHIRLEE",
        "middle_name": "BUCHANAN",
        "name_suffix": "Jr.",
        "credential": "DTLLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-20",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6352000466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Jean Moore
• Gwendolyn Layette Moore, RN
• Mary Moore, MA
• Pam Moore, MSW, LLMSW
• Rhonda Lynn Moore, DTLLP
• Shirley L. Moore
• Luis Angel Morales, OTRL
• Maria Morales
• Kathryn Moratti, NP
• Mary A. Morell, CRNA

• Counseling Psychologist in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Counseling Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; 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.