Active NPI
Elizabeth Moore
- Marriage & Family Therapist
- Grapevine, TX
National Provider Identifier
1639989593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 205873
- Practice address
- 414 N Main St Unit 103
Grapevine, TX 76051-3395 - Phone
- (817) 385-6264
- NPI assigned
- Jan 11, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 205873 | TX | Primary |
Addresses
Primary practice location
414 N Main St Unit 103
Grapevine, TX 76051-3395
Mailing address
1400 Dartmouth Dr
Southlake, TX 76092-7103
Other names 1
- Elizabeth Reed
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
| License | State | Type | Specialty |
|---|---|---|---|
| 205873 | TX | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736553600000",
"number": "1639989593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 DARTMOUTH DR",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760927103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "414 N MAIN ST UNIT 103",
"city": "GRAPEVINE",
"state": "TX",
"postal_code": "760513395",
"telephone_number": "817-385-6264"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-11",
"last_updated": "2025-01-11",
"certification_date": "2025-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "205873",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "REED",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Grapevine, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.