Moore Psychotherapy Care LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS015627 Issued in PA

Legal business name

MOORE PSYCHOTHERAPY CARE LLC

Practice address

2400 Chestnut St Apt 2810
Philadelphia, PA 19103-4325

Phone

(267) 879-4110

NPI assigned

Feb 9, 2014

Organization subpart

No

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

Authorized official

Name

Mark Anthony Moore, PH.D.NPI 1669690905

Title

Proprietor

Phone

(267) 879-4110

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Moore, PHD

  • Prescribing (Medical) Psychologist
  • Philadelphia, PA
  • NPI 1669690905
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1391904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708473600000",
    "number": "1265856447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 CHESTNUT ST APT 2810",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191034325",
            "telephone_number": "267-879-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 CHESTNUT ST APT 2810",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191034325",
            "telephone_number": "267-879-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORE PSYCHOTHERAPY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-09",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PROPRIETOR",
        "authorized_official_telephone_number": "267-879-4110",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS015627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayse Mooney, RN
• Kimberly Mooney
• Marlyn Mooney
• Melissa Mooney, M.ED, LBS
• Veronica Mooney, CRNA
• Sarah Princess Moore-Gaye
• Shannon Moore-Shabazz, DOULA/BIRTH WORKER
• Vernae Moore-Thompson, LSW
• Danica D Moore-Young, MSW, LSW
• Amanda Moore, MPT

• Clinical Psychologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.