Nico Moore, LPC,

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C.1700796 Issued in OH

Practice address

3100 E 45TH St Ste 212
Cleveland, OH 44127-1093

Phone

(216) 341-5510

Fax

(216) 341-5530

NPI assigned

Nov 27, 2017

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

Other names 1

• Nico Gilson Moore Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Family Solutions of Ohio Inc

  • Community/Behavioral Health Agency
  • Cincinnati, OH
  • NPI 1073949202
  NPD (past)

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

{
    "created_epoch": "1511740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511740800000",
    "number": "1669986873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3715 BAINBRIDGE RD",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441182243",
            "telephone_number": "216-262-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 E 45TH ST STE 212",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441271093",
            "telephone_number": "216-341-5510",
            "fax_number": "216-341-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "NICO",
        "credential": "LPC,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-27",
        "last_updated": "2017-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C.1700796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICO",
            "last_name": "MOORE",
            "middle_name": "GILSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mikyla Moore
• Monica Moore
• Monica Marie Moore
• Monique Moore
• Nathan Moore
• Nina Zobenica Moore, M.D.
• Ollica Moore
• Patricia H Moore, MD
• Paula Moore, RN
• Phillip Titus Moore, LPN

• Professional Counselor in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2017; 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.