Individual provider Active NPI

Charlene Ruth Moy, MS LMFT

  • Marriage & Family Therapist
  • Bainbridge Island, WA
National Provider Identifier
1225098767
Registry record updated Jan 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LF00002038 Issued in WA
Practice address
345 Knechtel Way NE
Ste. 206
Bainbridge Island, WA 98110-2860
Phone
(206) 930-0695
Fax
(206) 842-5444
NPI assigned
Mar 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LF00002038 WA Primary

Addresses

Primary practice location

345 Knechtel Way NE
Ste. 206
Bainbridge Island, WA 98110-2860

Mailing address

345 Knechtel Way NE
Ste. 206
Bainbridge Island, WA 98110-2860
Phone (206) 930-0695

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LF00002038WAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231891200000",
    "number": "1225098767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 KNECHTEL WAY NE",
            "address_2": "STE. 206",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981102860",
            "telephone_number": "206-930-0695",
            "fax_number": "206-842-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 KNECHTEL WAY NE",
            "address_2": "STE. 206",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981102860",
            "telephone_number": "206-930-0695",
            "fax_number": "206-842-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOY",
        "first_name": "CHARLENE",
        "middle_name": "RUTH",
        "name_prefix": "Ms.",
        "credential": "MS LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-27",
        "last_updated": "2009-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF00002038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2009; 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.