Charleszetta Moore, QMHP

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Practice address

4409 Disraeli Dr Apt 5101
Fort Worth, TX 76119-5851

Phone

(817) 585-0664

NPI assigned

Nov 1, 2022

Last updated

Nov 1, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1667260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1487361341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5125 WICHITA ST UNIT 15407",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761192501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4409 DISRAELI DR APT 5101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761195851",
            "telephone_number": "817-585-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHARLESZETTA",
        "credential": "QMHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-01",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashantay Moore
• Barbara J Moore, EDD
• Brittany Nicole Moore, DC
• Carol P Moore, RN
• Catherine Porter Moore, MD
• Craig M Moore, LSA
• Deborah Lynn Moore, LPC, LCSW
• Elora Moore, DPT
• Emily Taylor Moore
• Frank H Moore III, MD

• Case Management Agency in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Case Management Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; 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.