Nydesha Vinshay Moore

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P017334 Issued in NC

Practice address

3106 S Memorial Dr Ste B
Greenville, NC 27834-6765

Phone

(252) 916-6048

Fax

(252) 371-1655

NPI assigned

Mar 15, 2022

Last updated

Mar 15, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Yotaron Enrichment Resource Center

  • Counselor
  • Greenville, NC
  • NPI 1376945816
  NPD
• The Family Wellness Center PLLC

  • Marriage & Family Therapist
  • Greenville, NC
  • NPI 1497989842
  NPD (past)

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1801544242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31062",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278331062",
            "telephone_number": "252-367-3587",
            "fax_number": "252-371-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3106 S MEMORIAL DR STE B",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278346765",
            "telephone_number": "252-916-6048",
            "fax_number": "252-371-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "NYDESHA",
        "middle_name": "VINSHAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P017334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.yotaronerc.com",
            "affiliation": "N",
            "endpointDescription": "Company Website",
            "address_1": "3106 S Memorial Dr Ste B",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278346765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lesley Moore
• Lisa Moore, NP
• Madison Sara Moore, BSW
• Miranda M Moore, M.S., CCC-SLP
• Nicole Moore
• Opal Moore
• Patricia Brooke Moore, CPNP-AC
• Patrick Ryan Moore, D.M.D
• Robin Renee Moore, LCSW
• Ryan Thomas Moore, MD

• Clinical Social Worker in Greenville, NC
• Providers in Greenville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; 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.