Mark Moore, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

540 E 1St St
Waconia, MN 55387

Phone

(952) 442-4437

Fax

(952) 442-3084

NPI assigned

Aug 6, 2014

Last updated

Aug 9, 2018By the provider in NPPES

Sex

Male

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

Credentials

Master of Arts

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carver County

  dba Carver County Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waconia, MN
  • NPI 1326049685
  NPD (past)
• Edina Comfort Care Mental Health Walk-in Clinic LLC

  • Social Worker
  • Edina, MN
  • NPI 1861706863
  NPD (past)

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

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1548679384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9533 ROOSEVELT DR",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553174612",
            "telephone_number": "952-250-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 E 1ST ST",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "55387",
            "telephone_number": "952-442-4437",
            "fax_number": "952-442-3084"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4570 W 77th St Ste 315",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554355035",
            "country_code": "US",
            "telephone_number": "952-913-5403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-06",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Moe, PSYD, LP
• Dennis R Mohling, M.D.
• Laura A Mohling, M.D.
• Michelle R. Moldenhauer, LAMFT
• Thomas Edward Monsen, MSW LICSW
• Jackson T Moran
• Moravian Care Housing Corporation (Auburn Home in Waconia)
• Selena Morefield
• Kyle Morgenstern
• Nicole Morley

• Mental Health Counselor in Waconia, MN
• Providers in Waconia, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; 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.