Mary Austin Moore, MS, CRC, LCMHCA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A18560 Issued in NC

Practice address

153 Jefferson Church Rd
King, NC 27021-8605

Phone

(336) 692-3545

NPI assigned

Mar 1, 2023

Last updated

Mar 1, 2023By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Lydias Hope

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • King, NC
  • NPI 1972229383
  NPD

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

{
    "created_epoch": "1677628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1821797572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 FINWICK DR",
            "city": "PFAFFTOWN",
            "state": "NC",
            "postal_code": "270409043",
            "telephone_number": "336-692-3545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 JEFFERSON CHURCH RD",
            "city": "KING",
            "state": "NC",
            "postal_code": "270218605",
            "telephone_number": "336-692-3545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARY",
        "middle_name": "AUSTIN",
        "credential": "MS, CRC, LCMHCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A18560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Danielle Miller, FNP
• Tristyn Ann Mobley, LCSWA
• Harvey I Moles, DC
• Monarch
• Gary Vincent Monteith, DDS
• Donald Scott Morton
• Jody Lynn Nash, LPCA, LCASA
• Austin Newsom, PHARMD
• Samuel Carl Newsome, MD
• James Corey Norman

• Mental Health Counselor in King, NC
• Providers in King, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.