Terry Lynn Moore, MS, LPC, LCCA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

13412 Issued in TX

Practice address

5467 Rogers Hill Rd
West, TX 76691-2415

Phone

(254) 829-1893

Fax

(254) 829-1469

NPI assigned

Oct 3, 2019

Sex

Male

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 and National Provider Directory roles.

• Brookhaven Youth Ranch, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • West, TX
  • NPI 1740321686
  NPD (past)

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1841831534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5467 ROGERS HILL RD",
            "city": "WEST",
            "state": "TX",
            "postal_code": "766912415",
            "telephone_number": "254-829-1893",
            "fax_number": "254-829-1469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5467 ROGERS HILL RD",
            "city": "WEST",
            "state": "TX",
            "postal_code": "766912415",
            "telephone_number": "254-829-1893",
            "fax_number": "254-829-1469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TERRY",
        "middle_name": "LYNN",
        "credential": "MS, LPC, LCCA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-03",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "13412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brent P Komlofske, ATC, LAT
• Ruth Kuloba, COTA
• Charity Martin, COTA
• Cary McLevis
• Walter Jean Mellgren Jr., DC
• Nhci of Hillsboro Inc (West Clinic)
• Randy James Niemeyer, PHARMD
• Kira Nunn
• Old Corner Wellness Inc
• P S Well-Child Clinic

• Professional Counselor in West, TX
• Providers in West, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.