Coleen Moore

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180004169 Issued in IL

Practice address

1606 Hunt Dr
Normal, IL 61761-2192

Phone

(309) 452-0069

NPI assigned

May 4, 2022

Last updated

May 4, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gibson Community Hospital AssociationGroup PAC ID 5092703124, 159 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  Medicare reassignment Care Compare group NPD (past)
• Gibson Community Hospital Association

  dba Gibson Specialty Pharmacy

  • Community/Retail Pharmacy
  • Gibson City, IL
  • NPI 1245105535
  NPD
• Gibson Community Hospital Association

  dba Gibson Health of Urbana

  • Family Medicine Physician
  • Urbana, IL
  • NPI 1275403693
  NPD
• Lifelong Access

  • Behavior Analyst
  • Normal, IL
  • NPI 1831730092
  NPD (past)

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

{
    "created_epoch": "1651622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1730824616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 HUNT DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617612192",
            "telephone_number": "309-452-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 HUNT DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617612192",
            "telephone_number": "309-452-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "COLEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-04",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180004169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hollie Montenegro, COTA
• Virginia J Moody, MD
• Joseph Mooney, LCSW
• Moonflower Counseling PLLC
• Casey Moore
• Linda S Moorhead, MD
• Patrick Moraleda, RPH
• Susan Moreau, CST
• James Moreno, PHARM.D.
• Kimberly Moustoukkis

• Professional Counselor in Normal, IL
• Providers in Normal, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.