Charlene Moorer, NCC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

46-002009 Issued in CT

Practice address

36 N Main St
Southington, CT 06489-2517

Phone

(203) 919-2229

NPI assigned

Nov 13, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 29, 2024 through Mar 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• CDM Counseling & Consultation Services, LLC

  • Counselor
  • Wolcott, CT
  • NPI 1932764651
  NPD Authorized official

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

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595721600000",
    "number": "1295248250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 WOLCOTT RD STE 3",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067162641",
            "telephone_number": "860-329-7672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 N MAIN ST",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064892517",
            "telephone_number": "203-919-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORER",
        "first_name": "CHARLENE",
        "credential": "NCC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-13",
        "last_updated": "2020-07-26",
        "certification_date": "2020-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CT",
            "license": "241420",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "46-002009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008076655",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zuleyma Judith Molina Cardoso
• Maria Molinelli
• Amy Joan Mongillo, RDH
• Corinne Scarlett Mongillo, FNP
• Monica Marcello Nutrition
• Gisele Constanza Morini
• Leah Moskowitz, LCSW
• Laurie G Mozian, PHYSICAL THERAPIST
• Laura Stanton Mucci
• Mikayla Marie Mueller, RN

• Professional Counselor in Southington, CT
• Providers in Southington, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.