Susan I Moore, BA,CAC-AD

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

ACO239 Issued in MD

Practice address

122 Langley Rd N Ste a
Glen Burnie, MD 21060-6539

Phone

(410) 222-6725

Fax

(410) 222-6748

NPI assigned

Apr 16, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

State licenses

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679798417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1294 BRECKENRIDGE CIR",
            "city": "RIVA",
            "state": "MD",
            "postal_code": "211401341",
            "telephone_number": "410-222-6725",
            "fax_number": "410-222-6748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 LANGLEY RD N STE A",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210606539",
            "telephone_number": "410-222-6725",
            "fax_number": "410-222-6748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SUSAN",
        "middle_name": "I",
        "name_prefix": "Mrs.",
        "credential": "BA,CAC-AD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "ACO239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney Morgen Green Moomaw, MD
• Sarah Moon, L.AC
• Andrew David Moore, MD
• Deja Monae Moore, LMSW
• Jane S Moore, DO
• Tyrika Moore
• Jahkiiya Mooring
• Nilida E Mora Gutierrez, DDS
• Isabella Avila Moran
• Ramonia Morant, MA, LCPC, NCC

• Addiction (Substance Use Disorder) Counselor in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Addiction (Substance Use Disorder) Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.