Individual provider Active NPI

Allison Moore, LPC

  • Professional Counselor
  • Desoto, TX
National Provider Identifier
1316562275
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
78138 Issued in TX
Practice address
510 Shennandoah Dr
Desoto, TX 75115-2941
Phone
(214) 418-4410
NPI assigned
Jun 16, 2020
Last updated
Jun 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 78138 TX Primary

Addresses

Primary practice location

510 Shennandoah Dr
Desoto, TX 75115-2941

Mailing address

510 Shennandoah Dr
Desoto, TX 75115-2941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, VT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240109001223 TX Practitioner - Mental Health Counselor 1557712197 Reassigns benefits to 1 organization
I20260415001455 VT Practitioner - Mental Health Counselor 1557712197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

67 Eastern Ave
Suite 302
St Johnsbury, VT 05819-5642

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Connection to Recovery, LLC CurrentSince Jan 2, 2024 Accepting new patients
Shelby's Behavior Solutions Past Accepting new patients

Locations

14038 China Spring Rd
#13
China Spring, TX 76633
Phone (512) 334-6449

14038 China Spring Rd
Ste 13
China Spring, TX 76633

67 Eastern Ave
Ste 302
St Johnsbury, VT 05819
Phone (512) 334-6449

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1316562275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 SHENNANDOAH DR",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 SHENNANDOAH DR",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152941",
            "telephone_number": "214-418-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ALLISON",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-16",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "78138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

Verify at the official NPI Registry.