Juanese Moore, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC010471 Issued in GA

Practice address

4500 Hugh Howell Rd Ste 620D
Tucker, GA 30084-4720

Phone

(770) 609-7288

Fax

(470) 777-2790

NPI assigned

Sep 18, 2018

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Sep 3, 2025 through Sep 3, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: juanesemoore@tdh.allscriptsdirect.net

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.

• The Moore Experience

  • Community/Behavioral Health Agency
  • Tucker, GA
  • NPI 1649755281
  NPD Authorized official
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD

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

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1770067498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 ROCKBRIDGE RD NW STE 172-350",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300478225",
            "telephone_number": "770-609-7288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 HUGH HOWELL RD STE 620D",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844720",
            "telephone_number": "770-609-7288",
            "fax_number": "470-777-2790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Lee Byrd Rd",
            "address_purpose": "LOCATION",
            "city": "Loganville",
            "state": "GA",
            "postal_code": "300522310",
            "country_code": "US",
            "telephone_number": "770-609-7288",
            "fax_number": "470-777-2790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JUANESE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC010471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Monterola
• Montreal Internal Medicine Associates, PC
• Natasha Moon, PHD
• Danielle Moore, CCC-SLP
• Emily Moore
• Kathryn Marie Moore, RN, APRN-BC
• Lorneshia Moore, BCBA
• Ricquavious Moore, DPT
• Charlene Ann Morgan
• Antoinette Michelle Morris, MS

• Mental Health Counselor in Tucker, GA
• Providers in Tucker, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.