Active NPI
Connie Jung Moore, PHD, LPC
- Professional Counselor
- Guthrie, OK
National Provider Identifier
1902840960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3379
- Practice address
- 12352 Spring Cir
Guthrie, OK 73044-9772 - Phone
- (405) 473-3453
- NPI assigned
- Jun 16, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3379 | OK | Primary |
Addresses
Primary practice location
12352 Spring Cir
Guthrie, OK 73044-9772
Mailing address
12352 Spring Cir
Guthrie, OK 73044-9772
Phone (405) 473-3453
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 5, 2024 through Feb 5, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3379 | OK | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758240000000",
"number": "1902840960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12352 SPRING CIR",
"city": "GUTHRIE",
"state": "OK",
"postal_code": "730449772",
"telephone_number": "405-473-3453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12352 SPRING CIR",
"city": "GUTHRIE",
"state": "OK",
"postal_code": "730449772",
"telephone_number": "405-473-3453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "CONNIE",
"middle_name": "JUNG",
"credential": "PHD, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-16",
"last_updated": "2025-09-19",
"certification_date": "2025-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OK",
"license": "3379",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Guthrie, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; 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.