Carrie L Moore, MA, LMSW, CAAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6801062534 Issued in MI

Practice address

157 S Kalamazoo Mall
250
Kalamazoo, MI 49007-4877

Phone

(269) 383-1440

Fax

(269) 383-9781

NPI assigned

Jun 8, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271808000000",
    "number": "1518907229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 COBB AVE",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490072450",
            "telephone_number": "269-349-7148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 S KALAMAZOO MALL",
            "address_2": "250",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490074877",
            "telephone_number": "269-383-1440",
            "fax_number": "269-383-9781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CARRIE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "MA, LMSW, CAAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2010-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6801062534",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "C-02372",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMSW",
            "identifier": "6801062534",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAAC",
            "identifier": "C-02372",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Moon, ATC
• Kevin Moon
• Alexander Moore
• Allison Moore
• Andreea Gabriela Moore, MD
• Charles Moore, M.D.
• Courtney Christina Moore, BSW
• Dale G Moore, C.R.N.A.
• Dejanique Moore
• Delena Renee Moore

• Mental Health Counselor in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2010; 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.