Individual provider Active NPI

Christine M Moore, LPC, SW

  • Professional Counselor
  • Monona, WI
National Provider Identifier
1316376577
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6962-125 Issued in WI
Practice address
2001 W Broadway
Monona, WI 53713-3707
Phone
(608) 807-8632
NPI assigned
Nov 7, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6962-125 WI Primary
Social Worker 104100000X 39-120 WI

Addresses

Primary practice location

2001 W Broadway
Monona, WI 53713-3707

Mailing address

2001 W Broadway
Monona, WI 53713-3707
Phone (608) 807-8632

Other names 1

  • Mrs. Chris M Moore-Barbosa Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241217000797 WI Practitioner - Mental Health Counselor 3870020787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Talkspace Provider Network PAGroup PAC ID 5799136701, 249 clinicians

Practice addresses (Care Compare)

4026 S Burrell St
Milwaukee, WI 53207-4404
Phone (561) 221-5696

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6962-125WIMDProfessional Counselor
39-120WIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Talkspace Provider Network PA CurrentSince Dec 11, 2024 Accepting new patients

Locations

2578 Broadway
Ste 607
New York, NY 10025
Phone (304) 308-3735

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1316376577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 W BROADWAY",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537133707",
            "telephone_number": "608-807-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W BROADWAY",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537133707",
            "telephone_number": "608-807-8632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHRISTINE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LPC, SW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-07",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6962-125",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "39-120",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRIS",
            "last_name": "MOORE-BARBOSA",
            "middle_name": "M",
            "prefix": "MRS.",
            "credential": "LPC, SW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Monona, WI

Sources for this page

Verify at the official NPI Registry.