Natisha Monique Moore, PSY.D, M.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

944592654T Issued in AL

Practice address

PO Box 443
278 Mattooks Road
Maysville, NC 28555

Phone

(910) 358-8564

NPI assigned

Jul 15, 2026

Last updated

Jul 15, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1784073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1780503490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 443",
            "city": "MAYSVILLE",
            "state": "NC",
            "postal_code": "28555",
            "telephone_number": "910-358-8564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 443",
            "address_2": "278 MATTOOKS ROAD",
            "city": "MAYSVILLE",
            "state": "NC",
            "postal_code": "28555",
            "telephone_number": "910-358-8564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "NATISHA",
        "middle_name": "MONIQUE",
        "name_prefix": "Ms.",
        "credential": "PSY.D, M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-07-15",
        "last_updated": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "420764",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "944592654T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6D80D2AE3A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Guiding Light Peer Services, LLC
• Jubilee Education & Therapy, LLC
• Lane and Associates XL DDS PA
• Jacob Larkin
• Sue Ann Minneman-Fowler, DDS
• Nurses Plus Behavioral Health Services, LLC
• Pearls Family Care Home #1
• Quality Care Behavioral Health Services
• Rayven Michele Sims
• Sue a. Minneman-Fowler, DDS, PLLC

• Clinical Psychologist in Maysville, NC
• Providers in Maysville, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; 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.