Individual provider Active NPI

Tiffiny Jean Moore, LCMHC

  • Mental Health Counselor
  • Barre, VT
National Provider Identifier
1639476211
Registry record updated May 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
068-0057639 Issued in VT
Practice address
297 N Main St Ste 3
Barre, VT 05641-4503
Phone
(802) 793-9144
NPI assigned
Feb 17, 2011
Last updated
May 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 068-0057639 VT Primary

Addresses

Primary practice location

297 N Main St Ste 3
Barre, VT 05641-4503

Mailing address

PO Box 853
Barre, VT 05641-0853
Phone (802) 793-9144

Other identifiers 1

IdentifierTypeStateIssuer
1018762MedicaidVT

Other names 1

  • Tiffiny Jean Hubbard Former name

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

State licenses

LicenseStateTypeSpecialty
068-0057639VTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tiffiny Moore Counseling, LLC Mental Health CurrentSince May 10, 2020 Accepting new patients
Sarah D Counseling Services, LLC PastSince May 10, 2020 Accepting new patients

Locations

297 N Main St
Ste 3
Barre, VT 05641
Phone (802) 272-4037

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1639476211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 853",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056410853",
            "telephone_number": "802-793-9144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 N MAIN ST STE 3",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056414503",
            "telephone_number": "802-793-9144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TIFFINY",
        "middle_name": "JEAN",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-17",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "068-0057639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018762",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFINY",
            "last_name": "HUBBARD",
            "middle_name": "JEAN",
            "credential": "LCMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Barre, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; 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.