Individual provider Active NPI

Janice Moore, LPC

  • Professional Counselor
  • Hattiesburg, MS
National Provider Identifier
1497531677
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3014 Issued in MS
Practice address
105 N 40TH Ave
Hattiesburg, MS 39401-6606
Phone
(769) 390-7929
NPI assigned
Sep 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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 3014 MS Primary

Addresses

Primary practice location

105 N 40TH Ave
Hattiesburg, MS 39401-6606

Mailing address

PO Box 16805
Hattiesburg, MS 39404-6805
Phone (769) 390-7929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20231206004244 MS Practitioner - Mental Health Counselor 5395194021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

105 N 40TH Ave
Hattiesburg, MS 39401-6606
Phone (769) 390-7929

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3014MSMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Journeys Counseling Center LLC Professional CurrentSince Oct 18, 2023 Accepting new patients

Locations

105 N 40th Ave
Hattiesburg, MS 39401
Phone (601) 264-2692

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1497531677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16805",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394046805",
            "telephone_number": "769-390-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N 40TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394016606",
            "telephone_number": "769-390-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JANICE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-05",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "3014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.