Shannon Moore

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

16339 Issued in MD

Practice address

9627 Philadelphia Rd Ste 160
Rosedale, MD 21237-4157

Phone

(410) 780-5203

Fax

(410) 780-5205

NPI assigned

Mar 29, 2017

Sex

Female

Sole proprietor

Yes

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 MD

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 1

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Thrive Behavioral Health, LLC

  • Community/Behavioral Health Agency
  • Rosedale, MD
  • NPI 1053733378
  Medicare reassignment
• Henderson Family Services LLC

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1144768870
  NPD (past)

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1912439001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9627 PHILADELPHIA RD STE 160",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212374157",
            "telephone_number": "410-780-5203",
            "fax_number": "410-780-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9627 PHILADELPHIA RD STE 160",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212374157",
            "telephone_number": "410-780-5203",
            "fax_number": "410-780-5205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SHANNON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-29",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "16339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine E Mogollon Cabellos, LGPAT
• Caroline Elizabeth Mollenauer
• Angela Marie Monfiletto, AUD
• Katherine Monroe, LCPC
• Duane Richard Monteith, MD
• Vanessa Morales, LMSW
• Ian Biblanias Mores, CRNA
• Kia Morris
• Tesman L Morris
• Mosaic Community Services, Inc.

• Professional Counselor in Rosedale, MD
• Providers in Rosedale, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.