Mary Katherine Moore, LCMHCA, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A20249 Issued in NC

Practice address

Evolve Psych Group, PLLC 10706 Sikes Place, Suite 275
Charlotte, NC 28277

Phone

(704) 577-4071

NPI assigned

Jul 15, 2024

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

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.

• Evolve Psych Group, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waxhaw, NC
  • NPI 1356088389
  NPD (past)

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

{
    "created_epoch": "1721001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1750129813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EVOLVE PSYCH GROUP, PLLC 10706 SIKES PLACE, SUITE 275",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28277",
            "telephone_number": "704-577-4071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EVOLVE PSYCH GROUP, PLLC 10706 SIKES PLACE, SUITE 275",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28277",
            "telephone_number": "704-577-4071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "credential": "LCMHCA, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A20249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Anne Moore
• Maria Gaynier Moore, PA-C
• Marie Murphy Moore, NP
• Mark Benton Moore, ARNP
• Mary B Moore, LCSW
• Mary Katherine Heath Moore, DMD
• Mercy Rossana Bayot Moore, M.D.
• Monika Sheree Moore, MSW LCASA
• Naduri Moore
• Nancy C Moore, LPCA

• Mental Health Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.