Active NPI
Jennifer L. Moore, LMHC #8858
- Mental Health Counselor
- Groveland, MA
National Provider Identifier
1972810091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 8858
- Practice address
- 291 Main St
Groveland, MA 01834-1234 - Phone
- (978) 712-8023
- Fax
- (978) 388-8603
- NPI assigned
- Sep 10, 2010
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 8858 | MA | Primary |
Addresses
Primary practice location
291 Main St
Groveland, MA 01834-1234
Mailing address
291 Main St
Groveland, MA 01834-1234
Phone (978) 712-8023
Other practice location 1
57 Green St
Haverhill, MA 01830-5803
Other practice location 2
5 Market Sq
Amesbury, MA 01913-2497
Phone (978) 712-8023
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8858 | Other | MA | BOARD OF ALLIED MENTAL HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 1, 2024 through Nov 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8858 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1972810091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "291 MAIN ST",
"city": "GROVELAND",
"state": "MA",
"postal_code": "018341234",
"telephone_number": "978-712-8023",
"fax_number": "978-388-8603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "291 MAIN ST",
"city": "GROVELAND",
"state": "MA",
"postal_code": "018341234",
"telephone_number": "978-712-8023",
"fax_number": "978-388-8603"
}
],
"practiceLocations": [
{
"address_1": "57 Green St",
"address_purpose": "LOCATION",
"city": "Haverhill",
"state": "MA",
"postal_code": "018305803",
"country_code": "US",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5 Market Sq",
"address_purpose": "LOCATION",
"city": "Amesbury",
"state": "MA",
"postal_code": "019132497",
"country_code": "US",
"telephone_number": "978-712-8023",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOORE",
"first_name": "JENNIFER",
"middle_name": "L.",
"name_prefix": "Mrs.",
"credential": "LMHC #8858",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-10",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "8858",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF ALLIED MENTAL HEALTH",
"identifier": "8858",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Groveland, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.