Active NPI
Charlotte Haydon Moffitt, LPCC LPAT ATR BC
- Professional Counselor
- Lebanon, KY
National Provider Identifier
1770612327
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0422
- Practice address
- 1260 Simmstown Rd
Lebanon, KY 40033-8926 - Phone
- (859) 336-9825
- NPI assigned
- Mar 2, 2007
- Last updated
- May 16, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0422 | KY | Primary |
| Art Therapist | 221700000X | 92325 | KY |
Addresses
Primary practice location
1260 Simmstown Rd
Lebanon, KY 40033-8926
Mailing address
1260 Simmstown Rd
Lebanon, KY 40033-8926
Phone (859) 336-9825
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0422 | KY | MD | Professional Counselor |
| 92325 | KY | MD | Art Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305504000000",
"number": "1770612327",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1260 SIMMSTOWN RD",
"city": "LEBANON",
"state": "KY",
"postal_code": "400338926",
"telephone_number": "859-336-9825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1260 SIMMSTOWN RD",
"city": "LEBANON",
"state": "KY",
"postal_code": "400338926",
"telephone_number": "859-336-9825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOFFITT",
"first_name": "CHARLOTTE",
"middle_name": "HAYDON",
"name_prefix": "Mrs.",
"credential": "LPCC LPAT ATR BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-02",
"last_updated": "2011-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "KY",
"license": "0422",
"primary": true
},
{
"code": "221700000X",
"taxonomy_group": "",
"desc": "Art Therapist",
"state": "KY",
"license": "92325",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.