Mary C Moore, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS00371 Issued in RI

Practice address

203 S Main St
Providence, RI 02903-2992

Phone

(401) 273-4942

NPI assigned

Oct 11, 2005

Last updated

Nov 3, 2008By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225670400000",
    "number": "1407844723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029032992",
            "telephone_number": "401-273-4942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 S MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029032992",
            "telephone_number": "401-273-4942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-11",
        "last_updated": "2008-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS00371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moonstone Mothering Perinatal Services LLC
• Pamela Susan Moorby, RN
• Ashley Moore, M.A.,C.A.G.S.,C.R.C.
• Camilla Susan Moore, D.C.
• Kimberly Ann Moore
• Richard Anthony Moore, M.D.
• Sarah Anne Moore
• Shadae Moore
• Terri L Moore, NNP
• Thomas Edward Moore, DDS

• Clinical Psychologist in Providence, RI
• Providers in Providence, RI by specialty
• Clinical Psychologist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2008; 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.