Individual provider Active NPI

Alice Ann Moore, M.A.

  • Counseling Psychologist
  • Raleigh, NC
National Provider Identifier
1609903236
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
1692 Issued in NC
Practice address
8120 Pony Pasture CT
Raleigh, NC 27612-7378
Phone
(919) 881-0107
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 1692 NC Primary

Addresses

Primary practice location

8120 Pony Pasture CT
Raleigh, NC 27612-7378

Mailing address

8120 Pony Pasture CT
Raleigh, NC 27612-7378
Phone (919) 881-0107

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1692NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Moore Psychological Services, PLLC CurrentSince Jan 21, 2022 Accepting new patients

Locations

5561 McNeely Dr
Ste 202
Raleigh, NC 27612
Phone (919) 870-8151

Organizations & group practices 1

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609903236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8120 PONY PASTURE CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276127378",
            "telephone_number": "919-881-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8120 PONY PASTURE CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276127378",
            "telephone_number": "919-881-0107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ALICE",
        "middle_name": "ANN",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NC",
            "license": "1692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.