Individual provider Active NPI

Sobhuza Moore, M.A., LMHC, NCC

  • Mental Health Counselor
  • New York, NY
National Provider Identifier
1336532662
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P94094 Issued in NY
Practice address
124 E 40TH St RM 404
New York, NY 10016-1764
Phone
(646) 801-5316
NPI assigned
Mar 11, 2015
Last updated
Aug 22, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P94094 NY Primary

Addresses

Primary practice location

124 E 40TH St RM 404
New York, NY 10016-1764

Mailing address

PO Box 339
Bronx, NY 10463-0339
Phone (646) 801-5316

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
P94094NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Moore Mental Health Counseling Services, PLLC. Mental Health CurrentSince Dec 9, 2019 Accepting new patients

Locations

124 E 40th St
Rm 404
New York, NY 10016
Phone (646) 397-6096

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, 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": "1426032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1336532662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 339",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104630339",
            "telephone_number": "646-801-5316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E 40TH ST RM 404",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100161764",
            "telephone_number": "646-801-5316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SOBHUZA",
        "name_prefix": "Mr.",
        "credential": "M.A., LMHC, NCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-11",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P94094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.