Theresa Denise Moore, ED.D., LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC20270 Issued in AZ

Practice address

567 W Channel Islands Blvd # 203
Port Hueneme, CA 93041-2133

Phone

(480) 512-9500

NPI assigned

Jul 5, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Ms. Theresa Denise Everett Former name

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.

• Be Wellness, LLC

  • Community/Behavioral Health Agency
  • Tempe, AZ
  • NPI 1063178069
  NPD Authorized official

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

{
    "created_epoch": "1372982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1376983387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "567 W CHANNEL ISLANDS BLVD # 203",
            "city": "PORT HUENEME",
            "state": "CA",
            "postal_code": "930412133",
            "telephone_number": "480-512-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 W CHANNEL ISLANDS BLVD # 203",
            "city": "PORT HUENEME",
            "state": "CA",
            "postal_code": "930412133",
            "telephone_number": "480-512-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "THERESA",
        "middle_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "ED.D., LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-05",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.007134",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC20270",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "PC6401019591",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "EVERETT",
            "middle_name": "DENISE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Deana Medina
• Medstat Inc
• Karryn Messmer
• MJV Health Care Corp
• Alorah Michelle Molina
• Ramin Moravveji, DDS
• Kristal Marie Moreno
• Broc Allan Mushet, D.D.S.
• Nacc Port Huneme
• Andrew Guilmond Nadeau, IDC

• Mental Health Counselor in Port Hueneme, CA
• Providers in Port Hueneme, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; 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.