Crystal L Moore, MS CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL007475 Issued in PA

Practice address

127 N Brady St
Du Bois, PA 15801-2227

Phone

(814) 375-9615

NPI assigned

Nov 26, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Crystal L Lewis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Interim Healthcare of Western Pennsylvania Inc

  • Home Health Agency
  • Du Bois, PA
  • NPI 1417940487
  NPD (past)

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1467633958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 GREEN RIDGE DR",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158012337",
            "telephone_number": "814-371-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 N BRADY ST",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158012227",
            "telephone_number": "814-375-9615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CRYSTAL",
        "middle_name": "L",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-26",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL007475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "LEWIS",
            "middle_name": "L",
            "credential": "MS CCC/SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Joseph Mocik, LSW
• Cindy Ann Moilan, B. S. EDUCATION
• Mark Adam Theodore Molckovsky, MD
• Stephen Jennings Mollica, RPH
• Molly Monella, LPC
• Jeffrey Thomas Moore, RPH.
• Kevin Patrick Morrissey, CRNA
• Megan Morrow-Burkett, CRNP
• Moshannon Valley Psychiatric Services, PC
• Michael Anthony Motto, MD

• Speech-Language Pathologist in Du Bois, PA
• Providers in Du Bois, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2016; 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.