NPIMap

Organization Active NPI

Moore Balanced Minds & Therapies

  • Professional Counselor
  • Festus, MO
National Provider Identifier
1548042294
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
MOORE BALANCED MINDS & THERAPIES
Practice address
1170A E Gannon Dr
Festus, MO 63028-2604
Phone
(312) 581-9399
NPI assigned
Oct 17, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Authorized official

Name
Ms. Jamie A Moore, LPCNPI 1780366823
Title
Provider/Owner
Phone
(312) 581-9399

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

1170A E Gannon Dr
Festus, MO 63028-2604

Mailing address

1170A E Gannon Dr # a
Festus, MO 63028-2604
Phone (312) 581-9399

National Provider Directory

National Provider Directory

Locations

1170A E Gannon Dr
#A
Festus, MO 63028

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1697500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1548042294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170A E GANNON DR # A",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630282604",
            "telephone_number": "312-581-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170A E GANNON DR",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630282604",
            "telephone_number": "312-581-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORE BALANCED MINDS & THERAPIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-17",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "312-581-9399",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Festus, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.