Mollie Nicole Moore, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3722-57 Issued in WI

Practice address

7102 Mineral Point Rd
Madison, WI 53717

Phone

(608) 828-7611

Fax

(608) 828-7656

NPI assigned

Sep 9, 2016

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

Other names 1

• Mollie Nicole Gradel Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mmoore683393@direct.uwhealth.org

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.

• Journey Mental Health Center, Inc.

  • Case Management Agency
  • Madison, WI
  • NPI 1841413879
  NPD (past)

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

{
    "created_epoch": "1473379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1811444573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 UW HEALTH CT",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535625531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7102 MINERAL POINT RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53717",
            "telephone_number": "608-828-7611",
            "fax_number": "608-828-7656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "49 Kessel Ct",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537116275",
            "country_code": "US",
            "telephone_number": "608-280-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MOLLIE",
        "middle_name": "NICOLE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-09",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3722-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmoore683393@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "7102 Mineral Point Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "53717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MOLLIE",
            "last_name": "GRADEL",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Khara Moore
• Leyonita Moore, PH.D.
• Mark C Moore, MD
• Mary Moore, CNM
• McKenzie Kuehn Moore, LPC
• Rebecca Lynn Moore, PT
• Sarah C. Moore, M.D.
• Tiffany Nicole Moore, APSW
• Daniel Moorman
• A Vishnu Moorthy, MD

• Psychologist in Madison, WI
• Providers in Madison, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.