Individual provider Active NPI

Ashley Elizabeth Moore, LPC

  • Professional Counselor
  • Charleston, SC
National Provider Identifier
1780359778
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8437 Issued in SC
Practice address
125 Wappoo Creek Dr Ste D4
Charleston, SC 29412-2156
Phone
(864) 934-9764
NPI assigned
Aug 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 8437 SC Primary
Professional Counselor 101YP2500X 0701010677 VA

Addresses

Primary practice location

125 Wappoo Creek Dr Ste D4
Charleston, SC 29412-2156

Mailing address

493 Woodland Shores Rd
Charleston, SC 29412-2426
Phone (864) 934-9764

Other practice location 1

2312 Mount Vernon Ave Ste 206
Alexandria, VA 22301-1375
Phone (864) 934-9764

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
8437SCMDProfessional Counselor
0701010677VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Aem Wellness LLC CurrentSince Oct 20, 2024 Accepting new patients
Wonderologie LLC CurrentSince Aug 1, 2021 Accepting new patients

Locations

125 Wappoo Creek Dr
Ste D4
Charleston, SC 29412
Phone (864) 934-9764

2312 Mount Vernon Ave
Ste 206
Alexandria, VA 22301
Phone (703) 662-1591

Organizations & group practices 2

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": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1780359778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "493 WOODLAND SHORES RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294122426",
            "telephone_number": "864-934-9764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 WAPPOO CREEK DR STE D4",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294122156",
            "telephone_number": "864-934-9764"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2312 Mount Vernon Ave Ste 206",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223011375",
            "country_code": "US",
            "telephone_number": "864-934-9764",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ASHLEY",
        "middle_name": "ELIZABETH",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-11",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "8437",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701010677",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

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