Dustin Moore, LSAA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CSA0195451 Issued in NM

Practice address

511 E 20TH St
Farmington, NM 87401-2105

Phone

(505) 564-3733

NPI assigned

Mar 28, 2018

Last updated

Mar 28, 2018By the provider in NPPES

Sex

Male

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

State licenses

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1639674823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 E 20TH ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874012105",
            "telephone_number": "505-564-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 E 20TH ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874012105",
            "telephone_number": "505-564-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DUSTIN",
        "credential": "LSAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-28",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "CSA0195451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabelle Kathryn Montoya, CCC-SLP
• Jessica Montoya, CPSW
• Liann Montoya, RN SFA
• Christine Marie Moore, LMFT
• Christoper Moore, DC
• Mary Alma Moore, LPN
• Paul Robert Moore, RN, CRNA
• Roxie Moore, LSAA
• Stephanie Moore
• Eva Jean Morales, LCSW

• Addiction (Substance Use Disorder) Counselor in Farmington, NM
• Providers in Farmington, NM by specialty
• Addiction (Substance Use Disorder) Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; 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.