Active NPI
Laroy J Moore, PSYS
- School Psychologist
- Albuquerque, NM
National Provider Identifier
1356069637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 349297
- Practice address
- 10320 Cottonwood Park NW Ste a
Albuquerque, NM 87114-7008 - Phone
- (505) 250-5204
- NPI assigned
- Aug 22, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 349297 | NM | Primary |
Addresses
Primary practice location
10320 Cottonwood Park NW Ste a
Albuquerque, NM 87114-7008
Mailing address
4931 Kathryn Cir SE
Albuquerque, NM 87108-3501
Phone (505) 436-6684
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 |
|---|---|---|---|
| 349297 | NM | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661126400000",
"number": "1356069637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4931 KATHRYN CIR SE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871083501",
"telephone_number": "505-436-6684"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10320 COTTONWOOD PARK NW STE A",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871147008",
"telephone_number": "505-250-5204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "LAROY",
"middle_name": "J",
"credential": "PSYS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-08-22",
"last_updated": "2022-08-22",
"certification_date": "2022-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NM",
"license": "349297",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.