Kirsten Moore, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY003755 Issued in GA

Practice address

4080 McGinnis Ferry Rd
Ste. 204
Alpharetta, GA 30005-3948

Phone

(678) 644-0039

Fax

(678) 669-2740

NPI assigned

Sep 17, 2008

Last updated

Feb 26, 2014By the provider in NPPES

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

Opted out of Medicare

Yes, effective Jun 2, 2026 through Jun 2, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Balance & Potential Inc

  • Clinical Psychologist
  • Roswell, GA
  • NPI 1073906707
  Authorized official Same address or phone

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393372800000",
    "number": "1588813299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CHISWICK CLOSE",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300226675",
            "telephone_number": "678-644-0039",
            "fax_number": "678-669-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4080 MCGINNIS FERRY RD",
            "address_2": "STE. 204",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300053948",
            "telephone_number": "678-644-0039",
            "fax_number": "678-669-2740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KIRSTEN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2014-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY003755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanna Kaitlynn Moore
• Harmony BJ Moore
• John Gammon Moore, M.D.
• Joseph Moore
• Kevin Moore, L.P.C., C.A.C.
• Lamara Moore, RDH
• Robert Daniel Moore, DO
• Tiffany E. Moore
• Yolanda Renee Moore, D.D.S.
• Susan Mora, FNP

• Clinical Psychologist in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.