Jennifer Marie Moore

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

APC007037 Issued in GA

Practice address

1814 Clairmont Rd
Decatur, GA 30033-3405

Phone

(404) 636-1457

Fax

(404) 636-7449

NPI assigned

Aug 22, 2019

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

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 and National Provider Directory roles.

• Care and Counseling Center of Georgia, Inc.

  • Pastoral Counselor
  • Decatur, GA
  • NPI 1710012018
  NPD (past)

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1245887462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 CLAIRMONT RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333405",
            "telephone_number": "404-636-1457",
            "fax_number": "404-636-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 CLAIRMONT RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333405",
            "telephone_number": "404-636-1457",
            "fax_number": "404-636-7449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "189 Church St NE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300601629",
            "country_code": "US",
            "telephone_number": "404-636-1457",
            "fax_number": "404-636-7449",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "940 Concord Rd SE",
            "address_purpose": "LOCATION",
            "city": "Smyrna",
            "state": "GA",
            "postal_code": "300804204",
            "country_code": "US",
            "telephone_number": "404-636-1457",
            "fax_number": "404-636-7449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "APC007037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra L. Moore, PH.D.
• Harold Earl Moore Jr., M.D.
• Heather Moore, CNM
• Janice Chube Moore, L.C.S.W.
• Jennifer Elder Moore, LMSW
• Jocelyn Moore, SLP
• John Jay Moore
• Jonathan Charles Moore, PHARM.D.
• Latressa Aaliyah Moore
• Laurie Denise T Moore, NP

• Professional Counselor in Decatur, GA
• Providers in Decatur, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.