Dominique Michelle Moore

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

10326 Greenbriar Pkwy
Oklahoma City, OK 73159-7643

Phone

(405) 881-5057

NPI assigned

Jun 22, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dominique Michelle Roberson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498089600000",
    "number": "1386164275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10112 SPENCER JONES RD",
            "city": "SPENCER",
            "state": "OK",
            "postal_code": "730846900",
            "telephone_number": "405-413-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10326 GREENBRIAR PKWY",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597643",
            "telephone_number": "405-881-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DOMINIQUE",
        "middle_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2017-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOMINIQUE",
            "last_name": "ROBERSON",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chinyere Moore
• Clay W. Moore, D.PH.
• Deborah Moore, L.D.
• Deborah Jean Moore
• Derek Alan Moore
• Elizabeth Ann Moore, MA, LADC-MH
• Florence Moore
• Ginger Moore
• Hanah Moore
• Harrison Scott Moore, LGC

• Mental Health Counselor in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.

Verify at the official NPI Registry.