Amanda Jane Moore, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

11201 Issued in CA

Practice address

4700 Spring St Ste 203
La Mesa, CA 91942-0273

Phone

(619) 549-0329

NPI assigned

Feb 24, 2022

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

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Playful Expressions Child and Family Therapy

  • Mental Health Counselor
  • La Mesa, CA
  • NPI 1649061169
  NPD Authorized official

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

{
    "created_epoch": "1645660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1619623964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2763",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "919792763",
            "telephone_number": "619-634-7537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 SPRING ST STE 203",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919420273",
            "telephone_number": "619-549-0329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "AMANDA",
        "middle_name": "JANE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-24",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "11201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Ann Monchak
• Alvs Honrado Mondares, DPT
• Jeanne E Montal, M.D
• Irma Montegna
• Lubitza Montero
• Brian S Moore, MD
• Sally Anne Moore, PHARM.D.
• Karen Louise Moorehead-Jenkins, LCSW
• Anat Mor Betzalel
• Michele Morales-Silva

• Mental Health Counselor in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.