Jacob Alexander Moore, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

07251 Issued in MD

Practice address

9707 Key West Ave Ste 100
Rockville, MD 20850-3992

Phone

(240) 750-6467

NPI assigned

Aug 9, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Quince Orchard Psychotherapy LLCGroup PAC ID 5395194302, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Quince Orchard Psychotherapy LLC

  • Psychiatry Physician
  • Rockville, MD
  • NPI 1336670389

  DC, Mental Health

  Medicare reassignment Care Compare group NPD
• Oasis the Mental Health Center, LLC

  • Psychiatry Physician
  • Glen Burnie, MD
  • NPI 1174606057

  DC

  Medicare reassignment NPD
• Solace Grove Psychotherapy

  • Mental Health Counselor
  • Columbia, MD
  • NPI 1497629695
  NPD Authorized official
• Greater Baltimore Counseling Center, LLC

  • Clinical Psychologist
  • Glen Burnie, MD
  • NPI 1376616938
  NPD (past)
• Oasis the Mental Health Center, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Annapolis, MD
  • NPI 1467309138
  NPD (past)
• Quince Orchard Psychotherapy LLC

  • Clinical Social Worker
  • Nottingham, MD
  • NPI 1619895844

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1821762220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5822 BARNWOOD PL",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442842",
            "telephone_number": "301-272-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9707 KEY WEST AVE STE 100",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503992",
            "telephone_number": "240-750-6467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JACOB",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-09",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "A0611",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MD",
            "license": "07251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esha Moore
• Frederick DM Moore, MD
• Gregory Moore
• Ikea Moore
• India Moore
• Jada Moore
• Joan Moore, PSYD
• Kamirra Moore
• Karleigh Moore
• Kayla Moore

• Counseling Psychologist in Rockville, MD
• Providers in Rockville, MD by specialty
• Counseling Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.