Michaela Rae Moore

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

2024045907 Issued in MO

Practice address

410 Teaco Rd
Kennett, MO 63857-3239

Phone

(870) 565-9776

NPI assigned

Feb 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Palma Academy of Learning, LLC

  • Behavior Analyst
  • Paragould, AR
  • NPI 1891431300
  NPD (past)

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1942701503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 TEACO RD",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573239",
            "telephone_number": "870-565-9776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 TEACO RD",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573239",
            "telephone_number": "870-565-9776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "634 N 12th St",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "KY",
            "postal_code": "420711651",
            "country_code": "US",
            "telephone_number": "270-767-6415",
            "fax_number": "615-815-1946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MICHAELA",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-27",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "TN",
            "license": "0-23-14253",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "LA",
            "license": "RBT-17-29629",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MO",
            "license": "2024045907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Logan B Moody
• Shauna Moody
• Bridget Moore
• Caysie Michelle Moore
• Glenda Moore
• Lola Morelan, RASCA LL
• Leylani Marie Moreno
• Nadia Lizbeth Moreno, LCSW
• Jacqueline Michelle Morris
• Julie Lyn Morris, MCD, CCC-SLP

• Behavior Analyst in Kennett, MO
• Providers in Kennett, MO by specialty
• Behavior Analyst in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.