Vandevelde Moreno and Associates, LLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

VANDEVELDE MORENO AND ASSOCIATES, LLC

Practice address

601 Virginia Ave N Ste 1
Tifton, GA 31794-4268

Phone

(229) 396-5507

Fax

(229) 396-5093

NPI assigned

Mar 23, 2020

Last updated

Aug 13, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jessica Vandevelde Moreno, LMFTNPI 1285151175

Title

Marriage and Family Therapist

Phone

(229) 392-5273

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessica Vandevelde Moreno, LMFT

  • Marriage & Family Therapist
  • Tifton, GA
  • NPI 1285151175
  Authorized official Same address or phone

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628812800000",
    "number": "1356978118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1089",
            "city": "OMEGA",
            "state": "GA",
            "postal_code": "317751089",
            "telephone_number": "229-392-5273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 VIRGINIA AVE N STE 1",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944268",
            "telephone_number": "229-396-5507",
            "fax_number": "229-396-5093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANDEVELDE MORENO AND ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-23",
        "last_updated": "2021-08-13",
        "certification_date": "2021-02-13",
        "status": "A",
        "authorized_official_last_name": "VANDEVELDE MORENO",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "MARRIAGE AND FAMILY THERAPIST",
        "authorized_official_telephone_number": "229-392-5273",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jvmoreno.vma@outlook.com",
            "affiliation": "N",
            "address_1": "601 Virginia Ave N Ste 1",
            "city": "Tifton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "317944268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Marriage & Family Therapist in Tifton, GA
• Providers in Tifton, GA by specialty
• Marriage & Family Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.