Individual provider Active NPI

Terin Renee Moore, LCASA

  • Addiction (Substance Use Disorder) Counselor
  • New Bern, NC
National Provider Identifier
1770988552
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
1309 Tatum Dr
New Bern, NC 28560-4314
Phone
(252) 672-8742
Fax
(252) 638-6945
NPI assigned
Oct 23, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

1309 Tatum Dr
New Bern, NC 28560-4314

Mailing address

4300 Sapphire CT Ste 110
Greenville, NC 27834-9079
Phone (252) 830-7561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20240119000786 NC Practitioner - Mental Health Counselor 4082066691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5171 Glenwood Ave
Suite 211
Raleigh, NC 27612-3266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Port Health Services CurrentSince Jan 1, 2024 Accepting new patients
Port Health Services CurrentSince Jan 1, 2024 Accepting new patients
Easter Seals Ucp North Carolina & Virginia, Inc. CurrentSince Jul 1, 2024 Accepting new patients
Port Health Services Addiction (Substance Use Disorder) Current Accepting new patients
Easter Seals Ucp North Carolina & Virginia, Inc. CurrentSince Jul 1, 2024 Accepting new patients
Easter Seals Ucp North Carolina & Virginia, Inc. Current Accepting new patients
Easter Seals Ucp North Carolina & Virginia, Inc. Past Accepting new patients

Locations

2602 Courtier Dr
Greenville, NC 27834
Phone (252) 355-4725

4300 Sapphire Ct
Ste 110
Greenville, NC 27834
Phone (252) 830-7540

1309 Tatum Dr
New Bern, NC 28560
Phone (252) 672-2141

5171 Glenwood Ave
Ste 211
Raleigh, NC 27612
Phone (919) 210-7661

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1770988552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 SAPPHIRE CT STE 110",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278349079",
            "telephone_number": "252-830-7561",
            "fax_number": "252-413-0932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 TATUM DR",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285604314",
            "telephone_number": "252-672-8742",
            "fax_number": "252-638-6945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TERIN",
        "middle_name": "RENEE",
        "credential": "LCASA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-23",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

Verify at the official NPI Registry.