Active NPI
Bonnie Madeline Moore, MA, LPC
- Behavior Analyst
- Houston, TX
National Provider Identifier
1376633214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 19539 233304
- Practice address
- 1922 Wagon Gap TRL
Houston, TX 77090-1026 - Phone
- (281) 444-9553
- Fax
- (281) 444-9553
- NPI assigned
- Oct 13, 2006
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 19539 233304 | TX | |
| Forensic Psychologist | 103TF0200X | 19539 233304 | TX | |
| Behavior Analyst | 103K00000X | 19539 233304 | TX | Primary |
| Professional Counselor | 101YP2500X | 19539 233304 | TX | |
| Professional Counselor | 101YP2500X | 19539 | TX | |
| Psychoanalyst | 102L00000X | 19539 | TX |
Addresses
Primary practice location
1922 Wagon Gap TRL
Houston, TX 77090-1026
Mailing address
1922 Wagon Gap TRL
Houston, TX 77090-1026
Phone (281) 444-9553
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 760323389 | Other | TX | CIGNA HEALTHCARE |
| 256874 | Other | TX | OLD COMPSYCH |
| 570718 | Other | TX | VALUEOPTIONS MHS# |
| 11664355 | Other | TX | OLD AETNA BEHAVIORAL HEALTH |
| 1477756278 | Other | TX | PURPOSE PSYCHOLOGY NPI |
| 403328 | Other | TX | PURPOSE PSYCHOLOGY'S MHN # |
| 85495L | Other | TX | BCBS |
| H07190LC01 | Other | TX | OLD BCBS |
| 2554015 | Other | TX | CIGNA BEHAVIORAL HEALTH |
| 365283 | Other | TX | MHN PROVIDER ID |
| H00028QK01 | Other | TX | PURPOSE PSYCHOLOGY BCBS |
| H07280LC01 | Other | TX | OLD BCBS NUMBER |
| H085495L | Other | TX | BCBS FULL NUMBER |
| 21299221648 | Other | TX | BEECHSTREET |
| 9443845 | Other | TX | OLD PHCS MULTI-PLAN |
Other names 1
- Bonnie M Lindskog
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
| License | State | Type | Specialty |
|---|---|---|---|
| 19539 | TX | MD | Professional Counselor |
| 19539 233304 | TX | MD | Professional Counselor |
| 19539 233304 | TX | MD | Forensic Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Purpose Psychology | Behavior Analyst | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Behavior Analyst
- Houston, TX
- NPI 1477756278
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296345600000",
"number": "1376633214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1922 WAGON GAP TRL",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770901026",
"telephone_number": "281-444-9553",
"fax_number": "281-444-9553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1922 WAGON GAP TRL",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770901026",
"telephone_number": "281-444-9553",
"fax_number": "281-444-9553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "BONNIE",
"middle_name": "MADELINE",
"credential": "MA, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-13",
"last_updated": "2011-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "TX",
"license": "19539 233304",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "TX",
"license": "19539 233304",
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "TX",
"license": "19539 233304",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "19539 233304",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "19539",
"primary": false
},
{
"code": "102L00000X",
"taxonomy_group": "",
"desc": "Psychoanalyst",
"state": "TX",
"license": "19539",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTHCARE",
"identifier": "760323389",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OLD COMPSYCH",
"identifier": "256874",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUEOPTIONS MHS#",
"identifier": "570718",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OLD AETNA BEHAVIORAL HEALTH",
"identifier": "11664355",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PURPOSE PSYCHOLOGY NPI",
"identifier": "1477756278",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PURPOSE PSYCHOLOGY'S MHN #",
"identifier": "403328",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "85495L",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OLD BCBS",
"identifier": "H07190LC01",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA BEHAVIORAL HEALTH",
"identifier": "2554015",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN PROVIDER ID",
"identifier": "365283",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PURPOSE PSYCHOLOGY BCBS",
"identifier": "H00028QK01",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OLD BCBS NUMBER",
"identifier": "H07280LC01",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS FULL NUMBER",
"identifier": "H085495L",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEECHSTREET",
"identifier": "21299221648",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OLD PHCS MULTI-PLAN",
"identifier": "9443845",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "BONNIE",
"last_name": "LINDSKOG",
"middle_name": "M",
"credential": "LPC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.