Ann Jolene Moore, L.C.P.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCPC-3938 Issued in ID

Practice address

4696 W Overland Rd
Suite 118
Boise, ID 83705-2845

Phone

(208) 841-3581

Fax

(208) 906-8572

NPI assigned

Jan 14, 2008

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

• Ann Jolene Barrus Former name

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.

• A Balanced Life Experience

  • Mental Health Counselor
  • Boise, ID
  • NPI 1407171176
  NPD (past) Authorized official

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364860800000",
    "number": "1972789535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4696 W OVERLAND RD",
            "address_2": "SUITE 118",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837052845",
            "telephone_number": "208-841-3581",
            "fax_number": "208-906-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4696 W OVERLAND RD",
            "address_2": "SUITE 118",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837052845",
            "telephone_number": "208-841-3581",
            "fax_number": "208-906-8572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ANN",
        "middle_name": "JOLENE",
        "credential": "L.C.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-14",
        "last_updated": "2013-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-3938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "BARRUS",
            "middle_name": "JOLENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pamela Ellen Mooney
• Roseann T Mooney, D.M.D.
• Monty L Moore Johnson, LCPC
• Moore Wellness PLLC
• Alanna C Moore, PA-C
• Cassandre Lynn Moore, LCSW
• Emily Moore, PA-C
• Emily Theresa Moore, NURSE PRACTITIONER
• Erin Moore, RRT
• Gary L Moore, LCSW

• Mental Health Counselor in Boise, ID
• Providers in Boise, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2013; 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.