Charlyn Ann Moore, LMHC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH21958 Issued in FL

Practice address

5045 E Hinson Ave
Haines City, FL 33844-8872

Phone

(863) 557-3944

NPI assigned

Jul 26, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Purple Passion Enterprises, LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Haines City, FL
  • NPI 1790467611
  NPD Authorized official

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

{
    "created_epoch": "1690329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1538840251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5045 E HINSON AVE",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338448872",
            "telephone_number": "863-557-3944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5045 E HINSON AVE",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "338448872",
            "telephone_number": "863-557-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHARLYN",
        "middle_name": "ANN",
        "credential": "LMHC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-26",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH21958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edline Monestime
• Myrna C Monreal, MD
• Nicholas A Montes, PHARMD
• William A Moon, DDS
• Alyssa Nicole Moore
• Rosmery Morales Rodriguez
• Moranda Morancy, LMHC
• Namibia Moreno Cabrera
• Natalie Carol Mundy
• Edenid Maria Munoz, TCM

• Mental Health Counselor in Haines City, FL
• Providers in Haines City, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.