Mike Moody

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1302 Issued in TN

Practice address

165 Belle Forest Cir Ste a
Nashville, TN 37221-2174

Phone

(615) 852-5272

NPI assigned

Sep 10, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1992354120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2708 MOODY RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370407302",
            "telephone_number": "615-982-9232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 BELLE FOREST CIR STE A",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372212174",
            "telephone_number": "615-852-5272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "MIKE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TN",
            "license": "1302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF TENNESSEE",
            "identifier": "1302",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "transformationssaservices@gmail.com",
            "affiliation": "N",
            "address_1": "165 Belle Forest Cir Ste A",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372212174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica Moody, RDA
• Kara Moody, LPC-MHSP
• Kate Moody
• Lauren Goodson Moody, W.H.N.P.
• Leo James Moody, MD
• Samantha S Moody, APRN
• Shannon Nicole Moody, BSW
• Karin Coetzee Moolman, M.D.
• Caitlyn C Mooney, MD
• Rebecca A. Mooney, WHNP-BC

• Addiction (Substance Use Disorder) Counselor in Nashville, TN
• Providers in Nashville, TN by specialty
• Addiction (Substance Use Disorder) Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.