BRANDY MOORE (NPI# 1427667161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427667161 |
| Entity Type | Individual |
| Full Name | BRANDY MOORE |
| Practice Address |
200 N Emerald Ln Carbondale IL 62901-2159 |
| Mailing Address |
902 W Main St West Frankfort IL 62896-2210 |
| Practice Telephone | 6184576703 |
| Mailing Telephone | 6189376483 |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2020-07-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | IL2970 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336515410 | Brandy Lee Moore | Specialist | 100 Hunters Ln Ste 100, Tullahoma, TN 37388-8264 | 2015-08-12 |
| 1013349620 | Brandy Lee Moore | Occupational Therapy Assistant | 3309 Tinney Pl, Nashville, TN 37217-3457 | 2013-08-06 |
| 1679037956 | Brandy S Moore | Behavior Technician | 7109 Danny Dr, Stockton, CA 95210-5320 | 2019-01-30 |
| 1083127161 | Brandy M Moore | Nurse Practitioner | 255 Virginia Dr, Batesville, AR 72501-7335 | 2017-11-10 |
| 1386050912 | Brandy Moore | Pharmacist | 825 S Walnut St, Stillwater, OK 74074-4226 | 2014-07-02 |
| 1265853956 | Brandy Moore | Counselor | 5905 Forest Pl, Little Rock, AR 72207-5244 | 2013-12-23 |
| Street Address |
200 N EMERALD LN |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-2159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588630594 | Donald L Howard | Physical Therapy Assistant | 200 N Emerald Ln, Suite 1a, Carbondale, IL 62901-2100 | 2006-02-28 |
| 1225648652 | Trisha Fuller | Counselor | 200 N Emerald Ln, Carbondale, IL 62901-2159 | 2020-07-31 |
| 1043829450 | Chelsea Oschs | Counselor | 200 N Emerald Ln, Carbondale, IL 62901-2159 | 2020-07-31 |
| 1316282007 | Centerstone of Illinois, Inc | Community/Behavioral Health | 200 N Emerald Ln, Carbondale, IL 62901-2159 | 2012-12-06 |
| 1861602617 | Thomas Steven Portner | Physical Therapist | 200 N Emerald Ln, 1a, Carbondale, IL 62901-2100 | 2007-05-23 |
| 1265558449 | Claire Michele Shelton | Physical Therapy Assistant | 200 N Emerald Ln, Suite 1a, Carbondale, IL 62901-2100 | 2007-03-21 |
| 1760530224 | Robert Gough Landes | Physical Therapist | 200 N Emerald Ln, Suite 1a, Carbondale, IL 62901-2100 | 2007-01-08 |
| 1023023579 | Rehab Innovations LLC | Clinic/Center | 200 N Emerald Ln, Suite 1a, Carbondale, IL 62901-2100 | 2006-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831716844 | Valerie Newton | Counselor | 200 N Emerald Ln Ste 3, Carbondale, IL 62901-2170 | 2020-06-26 |
| 1235761784 | Ashley Ettinger | Counselor | 38 North Scott Road, Carbondale, PA 18407 | 2020-02-12 |
| 1356621528 | John Cosmo Obell | Counselor | 6 N Church St, St. Rose Rectory, Carbondale, PA 18407-2393 | 2011-08-19 |
| 1437456522 | Mary Elisabeth Jackson | Counselor | 804 South Oakland Ave, Carbondale, IN 62901 | 2011-02-25 |
| 1124299706 | Bonnie M Henry | Counselor | 602 S Wedgewood Ln, Carbondale, IL 62901-2119 | 2008-03-21 |
| 1699376517 | Taylor Holloway | Counselor | 200 N Emerald Ln Ste 3, Carbondale, IL 62901-2170 | 2020-11-06 |
| 1861009128 | Ashley Pruett | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-09-30 |
| 1477167823 | Zachary Woosley | Counselor | 2311 S Illinois Ave, Carbondale, IL 62903-5912 | 2020-09-03 |
| 1225648652 | Trisha Fuller | Counselor | 200 N Emerald Ln, Carbondale, IL 62901-2159 | 2020-07-31 |
| 1043829450 | Chelsea Oschs | Counselor | 200 N Emerald Ln, Carbondale, IL 62901-2159 | 2020-07-31 |
| Find all providers in CARBONDALE | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.