Individual provider Active NPI

Tanya Moore, LPCC

  • Professional Counselor
  • Hazard, KY
National Provider Identifier
1588038129
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
246344 Issued in KY
Practice address
115 Rockwood LN
Hazard, KY 41701-9415
Phone
(606) 436-5761
Fax
(606) 436-5797
NPI assigned
Nov 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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 246344 KY Primary

Addresses

Primary practice location

115 Rockwood LN
Hazard, KY 41701-9415

Mailing address

115 Rockwood LN
Hazard, KY 41701-9415
Phone (606) 436-5761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20240111004616 KY Practitioner - Mental Health Counselor 0446622799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD Moore LLCGroup PAC ID 6901278258, 4 clinicians

Practice addresses (Care Compare)

1031 Hwy 11 N
Beattyville, KY 41311-9240
Phone (606) 595-8431

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
246344KYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
MD Moore LLC CurrentSince Dec 24, 2021 Accepting new patients
MD Moore LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

1031 Highway 11 N
Beattyville, KY 41311
Phone (606) 595-8431

115 Rockwood Ln
Hazard, KY 41701
Phone (800) 575-7223

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Moore Care ClinicBeattyville, KY, CCN B03921 Rural health clinic 5% Or Greater Direct Ownership Interest (49%)
W-2 Managing Employee (49%)
Dec 24, 2021
Jan 1, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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": "1447891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1588038129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 ROCKWOOD LN",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019415",
            "telephone_number": "606-436-5761",
            "fax_number": "606-436-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 ROCKWOOD LN",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417019415",
            "telephone_number": "606-436-5761",
            "fax_number": "606-436-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TANYA",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-19",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "246344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazard, KY

Sources for this page

Verify at the official NPI Registry.