Organization Active NPI

Moments Matter Therapy PLLC

  • Marriage & Family Therapist
  • Jacksonville, NC
National Provider Identifier
1629702378
Registry record updated Jul 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
MOMENTS MATTER THERAPY PLLC
Practice address
200 Valencia Dr
Jacksonville, NC 28546-6311
Phone
(910) 939-0798
NPI assigned
Jul 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2022

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

Authorized official

Name
Trisha Johnson, LMFTNPI 1972149185
Title
Owner
Phone
(910) 939-0798

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

200 Valencia Dr
Jacksonville, NC 28546-6311

Mailing address

200 Valencia Dr
Jacksonville, NC 28546-6311

Other identifiers 1

IdentifierTypeStateIssuer
1972149185MedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1657411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657411200000",
    "number": "1629702378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 VALENCIA DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 VALENCIA DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466311",
            "telephone_number": "910-939-0798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMENTS MATTER THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-10",
        "last_updated": "2022-07-10",
        "certification_date": "2022-07-10",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "TRISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-939-0798",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972149185",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.