Breanne Moore, LMFT

Individual provider Active NPI Marriage & Family Therapist · Portland, TN

NPI 1821530627 · NPPES record last updated Nov 5, 2025

Key facts

NPI
1821530627
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
LMFT109213 (CA)
Practice address
201 N Broadway Ste C218
Portland, TN 37148-1111
Phone
(951) 532-6008
NPI assigned
Nov 9, 2016
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
IMF95818CAMDMarriage & Family Therapist
LMFT109213CAMDMarriage & Family Therapist
1934TNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Access Network Non Profit Corporation Past Accepting new patients
Sierra Counseling Psychotherapy, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1934 TN
Marriage & Family Therapist 106H00000X IMF95818 CA
Marriage & Family Therapist 106H00000X LMFT109213 CA Yes

Addresses

Primary practice location

201 N Broadway Ste C218
Portland, TN 37148-1111

Mailing address

201 N Broadway Ste C218
Portland, TN 37148-1111
Phone (951) 532-6008

Other practice location 1

1063 Deasy Ln
Portland, TN 37148-2232
Phone (951) 532-6008

Other providers in Portland, TN

All providers in Portland, TN · Marriage & Family Therapist in Tennessee

Sources for this page

Verify at the official NPI Registry.