Katelyn Richelle Moore, LPC, ATR

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

12662 Issued in NC

Practice address

110 E Oak Ave
Wake Forest, NC 27587-2152

Phone

(919) 601-3706

NPI assigned

Oct 1, 2018

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 28, 2023.

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1477038859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E OAK AVE",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275872152",
            "telephone_number": "919-601-3706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E OAK AVE",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275872152",
            "telephone_number": "919-601-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KATELYN",
        "middle_name": "RICHELLE",
        "credential": "LPC, ATR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-01",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "12662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Morton Montgomery, PHARMD
• Amanda Carmela Mooney, DPT
• Moonlight Pediatric Urgent Care PA
• Angela Moore, OTR/L
• Byron Moore, PT, DPT
• Matthew Moore, LICSW, LCSW, LISW-CP
• Morden Logistics LLC
• Dawn Morehead
• Alyson Moret, MS, CCC-SLP
• Chad Christopher Raymond Morgan, O.D.

• All providers in Wake Forest, NC
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.