Individual provider Active NPI

Rita D Moore, LPC

  • Professional Counselor
  • Glen Allen, VA
National Provider Identifier
1407271836
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
070100583 Issued in VA
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

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
30016134320003MedicaidVA

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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070100583VAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rhodium Care Group Inc CurrentSince Sep 6, 2024 Accepting new patients
Colonial Behavioral Health Past Accepting new patients
Colonial Behavioral Health PastSince Sep 1, 2005 Accepting new patients

Locations

8830 Virginia St
Amelia Ct Hse, VA 23002
Phone (804) 561-5611

Interoperability endpoints

  • FHIR API: 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.

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

Verify at the official NPI Registry.