Michal Sierra Moore, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

C7904 Issued in OR

Practice address

1500 NW Bethany Blvd Ste 320
Beaverton, OR 97006-5238

Phone

(503) 233-5405

NPI assigned

Dec 20, 2016

Last updated

Mar 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Michal Dedrick Former name

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.michaldedrick@148835.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brightspire Health, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Beaverton, OR
  • NPI 1518656776
  Medicare reassignment NPD
• Western Psychological and Counseling Services LLC

  dba LifeStance Health

  • Clinical Psychologist
  • Tacoma, WA
  • NPI 1912008178

  Counselor

  NPD (past)

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

{
    "created_epoch": "1482192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1417492851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20300 SE MORRISON TER APT F2039",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970302274",
            "telephone_number": "650-382-9218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 NW BETHANY BLVD STE 320",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970065238",
            "telephone_number": "503-233-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MICHAL",
        "middle_name": "SIERRA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-20",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "C7904",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "R7792",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAL",
            "last_name": "DEDRICK",
            "credential": "LPCA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eden Moore
• Elizabeth Adair Moore, AGPCNP-BC
• Jessica Moore, CRM
• Jessica C Moore
• Kelly Anne Moore, OT
• Nikki Moore, RDH
• Steven Philip Moore
• Gelsca Desindia Morales Felix
• Vanessa Morales
• Amber Moreno-Perez

• Counselor in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.

Verify at the official NPI Registry.