Individual provider Active NPI

Michael Scott Moore

  • Counselor
  • Hamilton, OH
National Provider Identifier
1801583067
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
CDCA.184050
Practice address
3103 Dixie Hwy
Hamilton, OH 45015-1653
Phone
(513) 892-4673
NPI assigned
Apr 19, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Case Manager/Care Coordinator 171M00000X
Counselor 101Y00000X CDCA.184050 Primary

Addresses

Primary practice location

3103 Dixie Hwy
Hamilton, OH 45015-1653

Mailing address

100 Crowne Point PL
Cincinnati, OH 45241-5427
Phone (513) 743-7628

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

Practice roles

OrganizationSpecialtyStatusNew patients
Decoach Team LLC CurrentSince Apr 23, 2023 Accepting new patients
Decoach Team LLC CurrentSince Apr 23, 2023 Accepting new patients

Locations

3103 Dixie Hwy
Hamilton, OH 45015
Phone (513) 892-4673

100 Crowne Point Pl
Sharonville, OH 45241
Phone (513) 743-7628

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1801583067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CROWNE POINT PL",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452415427",
            "telephone_number": "513-743-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3103 DIXIE HWY",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450151653",
            "telephone_number": "513-892-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-19",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": "CDCA.184050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; 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.