Courtney Lynn Moore, SUDPT

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CO61189828 Issued in WA

Practice address

3430 E Highway 101 Ste 3
Port Angeles, WA 98362-9069

Phone

(360) 452-4062

Fax

(360) 452-4189

NPI assigned

Jun 23, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Courtney Lynn Counterman Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Reflections Counseling Services Group

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Port Angeles, WA
  • NPI 1740569664
  NPD

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1336718360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 478",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983620072",
            "telephone_number": "360-452-4062",
            "fax_number": "360-452-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 E HIGHWAY 101 STE 3",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983629069",
            "telephone_number": "360-452-4062",
            "fax_number": "360-452-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "COURTNEY",
        "middle_name": "LYNN",
        "credential": "SUDPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WA",
            "license": "CO61189828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "courtney@rcsgpa.org",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3430 E Highway 101 Ste 3",
            "city": "Port Angeles",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983629069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "COUNTERMAN",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ricarda Annette Montague, SUDP
• Susan Montana, RN
• Kristina Lynn Montoya
• Andrew Jonathan Moon, LMP
• Alison Moore, MASSAGE THERAPIST
• Erik Stuart Mordecai-Smith
• Nicole Lynn Moreira, MA, AAC
• Leslie Morfeld, NAC
• Joni Morgan, RN
• Kori Gail Morgan, LMT

• All providers in Port Angeles, WA
• Professional Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.