Elisabeth J Tudor, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH0002430 Issued in FL

Practice address

1409 Kingsley Ave Ste 9D
Orange Park, FL 32073-4580

Phone

(904) 269-2931

Fax

(904) 212-2969

NPI assigned

Apr 19, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Lisa J Moore Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 29, 2026 through Jun 29, 2028

Medicare enrollment (NPD)

Not enrolled

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.

• Lisa J Moore LLC

  • Mental Health Counselor
  • Orange Park, FL
  • NPI 1093561987
  NPD Authorized official

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1881659183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 KINGSLEY AVE STE 9D",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734580",
            "telephone_number": "904-269-2931",
            "fax_number": "904-212-2969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 KINGSLEY AVE STE 9D",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734580",
            "telephone_number": "904-269-2931",
            "fax_number": "904-212-2969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUDOR",
        "first_name": "ELISABETH",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH0002430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "MOORE",
            "middle_name": "J",
            "credential": "LLC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• John Tumba Tshimbalanga
• Elias Tsirakoglou, D.O.
• Ador Tuazon, PT
• Ladonna Maria Tucker-Dennis
• Bruce Alan Tucker, RPH
• Lilibeth Tulang Cuevas, ARNP
• Tony Tullot, MD
• Amy E Turner, PTA
• Colleen Turner, OTR-L
• Emily Rose Turner, BT

• Mental Health Counselor in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.