Charles R. Moody, CADC-R

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

T-24-4236 Issued in OR

Practice address

1160 Liberty St SE
Salem, OR 97302-4143

Phone

(503) 391-9762

Fax

(503) 315-2019

NPI assigned

Aug 26, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Rob Moody Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• CRC Health Oregon, LLC

  • Methadone Clinic
  • Salem, OR
  • NPI 1427397074
  NPD (past)
• CRC Health Oregon, LLC

  • Methadone Clinic
  • Albany, OR
  • NPI 1811561731
  NPD (past)

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1437983293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024143",
            "telephone_number": "503-391-9762",
            "fax_number": "503-315-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024143",
            "telephone_number": "503-391-9762",
            "fax_number": "503-315-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "CHARLES",
        "middle_name": "R.",
        "credential": "CADC-R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-24-4236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROB",
            "last_name": "MOODY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Karen Montero
• Leonor Carolina Montes
• Chelsea Ann Montgomery, EPDH
• Mark Woodrow Montgomery, DMD
• Lizeth Montoya Breidenbach
• Meagan Mook
• Amanda M Mooney
• James Patrick Mooney, PH.D.
• Kurt Mooney, BC-HIS
• Marlene Mooney, RN

• Addiction (Substance Use Disorder) Counselor in Salem, OR
• Providers in Salem, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.