Active NPI
Dorothy Ann Moore, MS, LMHC, NCC
- Mental Health Counselor
- Shoreline, WA
National Provider Identifier
1932701901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH61234726
- Practice address
- 17018 15TH Ave NE
Shoreline, WA 98155-5137 - Phone
- (206) 362-7282
- NPI assigned
- Nov 13, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MC60896349 | WA | |
| Mental Health Counselor | 101YM0800X | LH61234726 | WA | Primary |
Addresses
Primary practice location
17018 15TH Ave NE
Shoreline, WA 98155-5137
Mailing address
19720 Bing Rd
Lynnwood, WA 98036-7118
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH61234726 | WA | MD | Mental Health Counselor |
| MC60896349 | WA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sandbox Therapy Group, Inc. | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686873600000",
"number": "1932701901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19720 BING RD",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980367118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17018 15TH AVE NE",
"city": "SHORELINE",
"state": "WA",
"postal_code": "981555137",
"telephone_number": "206-362-7282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "DOROTHY",
"middle_name": "ANN",
"credential": "MS, LMHC, NCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-13",
"last_updated": "2023-06-16",
"certification_date": "2023-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MC60896349",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH61234726",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Shoreline, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.