Individual provider Active NPI

Victoria Moon

  • Professional Counselor
  • Philadelphia, PA
National Provider Identifier
1447943089
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC017541 Issued in PA
Practice address
1156 E Slocum St
Philadelphia, PA 19150-3123
Phone
(267) 329-9547
NPI assigned
May 30, 2023
Last updated
Oct 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 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 NU
Professional Counselor 101YP2500X PC017541 PA Primary

Addresses

Primary practice location

1156 E Slocum St
Philadelphia, PA 19150-3123

Mailing address

1156 E Slocum St
Philadelphia, PA 19150-3123
Phone (267) 329-9547

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20241024000806 PA Practitioner - Mental Health Counselor 0941733398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

1800 JFK Blvd
Suite 1404
Philadelphia, PA 19103-7417
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC Mental Health CurrentSince Oct 11, 2024 Accepting new patients

Locations

5830 Ellsworth Ave
Ste 301
Pittsburgh, PA 15232
Phone (412) 208-6279

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1685404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1447943089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1156 E SLOCUM ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191503123",
            "telephone_number": "267-329-9547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 E SLOCUM ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191503123",
            "telephone_number": "267-329-9547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "VICTORIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-30",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC017541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.