Alexis Kaybrook Moore, MPH, CAAR

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CG61025586 Issued in WA

Practice address

403 W State St Ste 206
Aberdeen, WA 98520-6140

Phone

(360) 986-0996

NPI assigned

Mar 5, 2020

Last updated

Mar 5, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Alexis Kaybrook Bertsch 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": "1583366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1205461787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 W STATE ST STE 206",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985206140",
            "telephone_number": "360-986-0996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W STATE ST STE 206",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985206140",
            "telephone_number": "360-986-0996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ALEXIS",
        "middle_name": "KAYBROOK",
        "name_prefix": "Mrs.",
        "credential": "MPH, CAAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-05",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG61025586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXIS",
            "last_name": "BERTSCH",
            "middle_name": "KAYBROOK",
            "credential": "MPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• MK Behavioral Services
• Shane Lee Moe
• April M Monroe, LCSW
• Stephen Paul Montoure, CDPT
• Keri Lynn Moonen, HIS
• Andrew Seth Moore
• Sarah Moore
• Yancy Moore, CDP
• Shana Morgan
• Anna Diane Morris, SUDPT

• Mental Health Counselor in Aberdeen, WA
• Providers in Aberdeen, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; 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.