Olivia Marie Moore

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A20759 Issued in NC

Practice address

309 W Millbrook Rd Ste 151
Raleigh, NC 27609-4261

Phone

(919) 559-8690

NPI assigned

Nov 7, 2024

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

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

{
    "created_epoch": "1730937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1205650140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3213 LAKE WOODARD DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276043660",
            "telephone_number": "919-793-6252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 W MILLBROOK RD STE 151",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094261",
            "telephone_number": "919-559-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "OLIVIA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-07",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "NC",
            "license": "1261992",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A20759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Kepke Moore, M.D.
• Merideth Moore
• Morgana M Moore, PT
• Nathaniel Moore
• Nyla Moore
• Parker Davis Moore, PA-C
• Rachael Moore
• Raegan Arielle Moore, LCMHCA
• Samantha Tyler Moore, LCMHC
• Samuel Edward Moore, PHARMD

• Mental Health Counselor in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.