Active NPI
Kathleen McGuire-Moore, PH.D.
- Clinical Psychologist
- Troy, MI
National Provider Identifier
1427188754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301005835
- Practice address
- 755 W Big Beaver Rd
Troy, MI 48084-4900 - Phone
- (248) 546-8914
- Fax
- (248) 269-6047
- NPI assigned
- Mar 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301005835 | MI | Primary |
Addresses
Primary practice location
755 W Big Beaver Rd
Troy, MI 48084-4900
Mailing address
817 Lockwood Rd
Royal Oak, MI 48067-1609
Phone (248) 546-8914
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 680-F3-3047 | Other | MI | BCBS PIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301005835 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1427188754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "817 LOCKWOOD RD",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480671609",
"telephone_number": "248-546-8914",
"fax_number": "248-269-6047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "755 W BIG BEAVER RD",
"city": "TROY",
"state": "MI",
"postal_code": "480844900",
"telephone_number": "248-546-8914",
"fax_number": "248-269-6047"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGUIRE-MOORE",
"first_name": "KATHLEEN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301005835",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PIN",
"identifier": "680-F3-3047",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.