Active NPI
Delina L Moore
- Addiction (Substance Use Disorder) Psychologist
- Batavia, OH
National Provider Identifier
1356852453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Psychologist
- License
- LCDCIII.161438
- Practice address
- 1088 Wasserman Way
Batavia, OH 45103-1974 - Phone
- (513) 354-5200
- NPI assigned
- Oct 16, 2017
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | LCDCIII.161438 | OH | Primary |
Addresses
Primary practice location
1088 Wasserman Way
Batavia, OH 45103-1974
Mailing address
1088 Wasserman Way
Batavia, OH 45103-1974
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LCDIII.161438 | Other | OH | LICENSURE |
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 |
|---|---|---|---|
| LCDCIII.161438 | OH | MD | Addiction (Substance Use Disorder) Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508112000000",
"number": "1356852453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1088 WASSERMAN WAY",
"city": "BATAVIA",
"state": "OH",
"postal_code": "451031974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1088 WASSERMAN WAY",
"city": "BATAVIA",
"state": "OH",
"postal_code": "451031974",
"telephone_number": "513-354-5200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "DELINA",
"middle_name": "L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-16",
"last_updated": "2017-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "LCDCIII.161438",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSURE",
"identifier": "LCDIII.161438",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Batavia, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.