Active NPI
Lynn Moore
- Mental Health Counselor
- Johnston, IA
National Provider Identifier
1326224486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 00702
- Practice address
- 5415 NW 88TH St
Ste 100
Johnston, IA 50131-2950 - Phone
- (515) 727-1338
- NPI assigned
- Jan 18, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 00702 | IA | Primary |
Addresses
Primary practice location
5415 NW 88TH St
Ste 100
Johnston, IA 50131-2950
Mailing address
5415 NW 88TH St
Ste 100
Johnston, IA 50131-2950
Phone (515) 727-1338
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00702 | IA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200614400000",
"number": "1326224486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5415 NW 88TH ST",
"address_2": "STE 100",
"city": "JOHNSTON",
"state": "IA",
"postal_code": "501312950",
"telephone_number": "515-727-1338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5415 NW 88TH ST",
"address_2": "STE 100",
"city": "JOHNSTON",
"state": "IA",
"postal_code": "501312950",
"telephone_number": "515-727-1338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "LYNN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-18",
"last_updated": "2008-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "00702",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johnston, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.