Individual provider Active NPI

Audrey Durand Moore, LPC

  • Professional Counselor
  • Newport News, VA
National Provider Identifier
1467412403
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
07010022742 Issued in VA
Practice address
703 Thimble Shoals Blvd
Suite a-3
Newport News, VA 23606-2576
Phone
(757) 873-2307
Fax
(757) 873-3401
NPI assigned
Mar 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 07010022742 VA Primary

Addresses

Primary practice location

703 Thimble Shoals Blvd
Suite a-3
Newport News, VA 23606-2576

Mailing address

703 Thimble Shoals Blvd
Suite a-3
Newport News, VA 23606-2576
Phone (757) 873-2307

Other identifiers 1

IdentifierTypeStateIssuer
0101102189MedicaidVA

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

State licenses

LicenseStateTypeSpecialty
07010022742VAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1467412403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 THIMBLE SHOALS BLVD",
            "address_2": "SUITE A-3",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062576",
            "telephone_number": "757-873-2307",
            "fax_number": "757-873-3401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 THIMBLE SHOALS BLVD",
            "address_2": "SUITE A-3",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062576",
            "telephone_number": "757-873-2307",
            "fax_number": "757-873-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "AUDREY",
        "middle_name": "DURAND",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "07010022742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0101102189",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.