Individual provider Active NPI

Anna Moore, LMHC

  • Mental Health Counselor
  • Maitland, FL
National Provider Identifier
1740504562
Registry record updated Apr 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH12504 Issued in FL
Practice address
1009 Maitland Center Commons Blvd
#212
Maitland, FL 32751-7270
Phone
(800) 840-2528
NPI assigned
Mar 23, 2010
Last updated
Apr 28, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH12504 FL Primary

Addresses

Primary practice location

1009 Maitland Center Commons Blvd
#212
Maitland, FL 32751-7270

Mailing address

1009 Maitland Center Commons Blvd
#212
Maitland, FL 32751-7270
Phone (800) 840-2528

Other identifiers 1

IdentifierTypeStateIssuer
12356400MedicaidFL

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

LicenseStateTypeSpecialty
MH12504FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1269302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493337600000",
    "number": "1740504562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 MAITLAND CENTER COMMONS BLVD",
            "address_2": "#212",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517270",
            "telephone_number": "800-840-2528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 MAITLAND CENTER COMMONS BLVD",
            "address_2": "#212",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517270",
            "telephone_number": "800-840-2528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ANNA",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-23",
        "last_updated": "2017-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH12504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12356400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

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