Active NPI
Rita D Moore, LPC
- Professional Counselor
- Glen Allen, VA
National Provider Identifier
1407271836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 070100583
- Practice address
- 10900 Nuckols Rd Ste 100
Glen Allen, VA 23060-9277 - Phone
- (804) 207-6737
- NPI assigned
- Feb 21, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 070100583 | VA | |
| Professional Counselor | 101YP2500X | 070100583 | VA | Primary |
Addresses
Primary practice location
10900 Nuckols Rd Ste 100
Glen Allen, VA 23060-9277
Mailing address
10900 Nuckols Rd Ste 100
Glen Allen, VA 23060-9277
Phone (804) 207-6737
Other practice location 1
5360 Discovery Park Blvd Ste 201
Williamsburg, VA 23188-2860
Phone (804) 207-6737
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30016134320003 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070100583 | VA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rhodium Care Group Inc | Current | Accepting new patients | |
| Colonial Behavioral Health | Past | Accepting new patients | |
| Colonial Behavioral Health | Past | Accepting new patients |
Locations
8830 Virginia St
Amelia Ct Hse, VA 23002
Phone (804) 561-5611
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/2b8c86f5-c497-45b0-94ed-0102e20d1c70/
Organizations & group practices 3
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.
-
- Psychologist
- Lakewood, NJ
- NPI 1235853698
-
- Community/Behavioral Health Agency
- Williamsburg, VA
- NPI 1760565915
-
- Health Maintenance Organization
- Williamsburg, VA
- NPI 1841556776
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730678400000",
"number": "1407271836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10900 NUCKOLS RD STE 100",
"city": "GLEN ALLEN",
"state": "VA",
"postal_code": "230609277",
"telephone_number": "804-207-6737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10900 NUCKOLS RD STE 100",
"city": "GLEN ALLEN",
"state": "VA",
"postal_code": "230609277",
"telephone_number": "804-207-6737"
}
],
"practiceLocations": [
{
"address_1": "5360 Discovery Park Blvd Ste 201",
"address_purpose": "LOCATION",
"city": "Williamsburg",
"state": "VA",
"postal_code": "231882860",
"country_code": "US",
"telephone_number": "804-207-6737",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOORE",
"first_name": "RITA",
"middle_name": "D",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-21",
"last_updated": "2024-11-04",
"certification_date": "2024-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VA",
"license": "070100583",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VA",
"license": "070100583",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30016134320003",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Glen Allen, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.