TRACY J MOORE (NPI# 1558614677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558614677 |
| Entity Type | Individual |
| Full Name | TRACY J MOORE |
| Credential | LCAS-A |
| Practice Address |
5500 Executive Center Dr Charlotte NC 28212-8856 |
| Practice Telephone | 7045375760 |
| Mailing Telephone | 7045375760 |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2016-09-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | LCAS-15519 | NC | Behavioral Health & Social Service Providers |
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LCAS-15519 | NC | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
LCAS-15519 | NC | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
P007403 | NC | Behavioral Health & Social Service Providers |
| N | 172V00000X | Community Health Worker | LCAS-15519 | NC | Other Service Providers |
| N | 171M00000X | Case Manager/Care Coordinator | LCAS-15519 | NC | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598130395 | Tracy Moore | Licensed Practical Nurse | 2 Laura Ln, Otisville, NY 10963-2316 | 2015-12-04 |
| 1154536134 | Tracy Lenore Moore | Licensed Practical Nurse | 1046 Lakegrove Ct, Westerville, OH 43081-1958 | 2007-05-11 |
| 1497388417 | Tracy Moore | Physical Medicine & Rehabilitation | 1335 Cypress St Ste 100, San Dimas, CA 91773-3538 | 2020-02-18 |
| 1538711510 | Tracy Moore | Behavior Technician | 9480 Three Rivers Rd, Gulfport, MS 39503-4248 | 2019-07-10 |
| 1982143152 | Tracy Leigh Moore | Case Manager/Care Coordinator | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2017-02-21 |
| 1144684358 | Tracy Moore | Technician | 419 N Broadway, Locust Grove, OK 74352-5020 | 2016-04-13 |
| 1588024483 | Tracy Moore | Dietitian, Registered | 3220 Providence Dr, Suite E3-030, Anchorage, AK 99508-4679 | 2016-03-04 |
| 1457743221 | Tracy Moore | Social Worker | 654 Ne 9th Pl, Homestead, FL 33030-4934 | 2015-03-03 |
| 1861716649 | Tracy Moore | Physical Therapist | 40 N Main St, Bellingham, MA 02019-1590 | 2010-03-23 |
| 1417188558 | Tracy C. Moore | Registered Nurse | 830 S Limestone Street, Lexington, KY 40536-2477 | 2009-08-06 |
| Street Address |
5500 EXECUTIVE CENTER DR |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28212-8856 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952326563 | Hilltop Comprehensive Care, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 5500 Executive Center Dr, Suite 202, Charlotte, NC 28212-8856 | 2006-07-13 |
| 1578079604 | Homecare Management Corporation | Clinic/Center | 5500 Executive Center Dr, Charlotte, NC 28212-8856 | 2017-12-27 |
| 1740621200 | Rha Howell Care Center | Community/Behavioral Health | 5500 Executive Center Dr, Charlotte, NC 28212-8856 | 2013-07-12 |
| 1568702934 | Alliance Health and Human Services | Case Management | 5500 Executive Center Dr, Suite 204, Charlotte, NC 28212-8856 | 2013-02-22 |
| 1578807657 | Thy Nguyen-jones | Counselor | 5500 Executive Center Dr, Charlotte, NC 28212-8856 | 2012-11-15 |
| 1437401023 | Courtney S Jones | Counselor | 5500 Executive Center Dr, Charlotte, NC 28212-8856 | 2012-10-08 |
| 1366792053 | Shatara Marshall | Social Worker | 5500 Executive Center Dr, Charlotte, NC 28212-8856 | 2012-09-11 |
| 1619207990 | Nextstep Family Counseling | Community/Behavioral Health | 5500 Executive Center Dr, Suite 202, Charlotte, NC 28212-8856 | 2010-01-08 |
| 1831423672 | Miracle Houses, Inc. | Community/Behavioral Health | 5500 Executive Center Dr, Ste. 201, Charlotte, NC 28212-8856 | 2009-09-28 |
| 1801023114 | Miracle Houses, Incorporated | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5500 Executive Center Dr, Ste. 201, Charlotte, NC 28212-8856 | 2009-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371250 | Amy Sierra Conner | Counselor | 5700 Executive Drive Suite 110, Charlotte, NC 28212 | 2019-11-25 |
| 1700447307 | Nagarani Nagarajan Dds.,pllc | Clinic/Center | 2510 Vista Drive, Suite 100, Charlotte, NC 28212 | 2019-06-25 |
| 1700441011 | Khadija Brown | Counselor | 6601 English Hills Dr, Charlotte, NC 28212 | 2019-05-02 |
| 1245711514 | Savannah Huneycutt | Dentist | 6708 Albemarle Road, Charlotte, NC 28212 | 2018-08-24 |
| 1417435710 | Porcelain Dolls of The Carolinas, Inc | Clinic/Center | 5835 Executive Center Dr # 101-i, Charlotte, NC 28212 | 2018-07-30 |
| 1447701511 | Christine Walker Physical Therapy, LLC | Clinic/Center | 8850 Monroe Rd, Charlotte, NC 28212 | 2016-10-24 |
| 1013376128 | Colby Edward Joyner | Physician Assistant | 7005 Wallace Rd Ste 600, Charlotte, NC 28212 | 2016-02-17 |
| 1760814412 | Nguyen Tri Nguyen, Dds, Pa | Dentist | 6404 Albemarle Road, #c, Charlotte, NC 28212 | 2013-08-05 |
| 1477806834 | Tara Thompson | Counselor | 6900 Democracy Dr., Charlotte, NC 28212 | 2012-10-23 |
| 1568711109 | Mary Dianne Branch | Counselor | 8130 Runaway Bay Drive Apt Q, Charlotte, NC 28212 | 2012-08-29 |
| Find all providers in zip 28212 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619574829 | Steve Hanna Interventions | Counselor | 8101 Providence Court Ln Apt 101, Charlotte, NC 28270-2385 | 2020-10-01 |
| 1164036976 | Diamond Corbin | Counselor | 3553 N Sharon Amity Rd Ste 200, Charlotte, NC 28205-8992 | 2020-08-31 |
| 1366053035 | Triumph Therapeutic Services Pllc | Counselor | 620 Parkaire Ln Apt 1024, Charlotte, NC 28217-2492 | 2020-08-14 |
| 1407472582 | Sarah Ann Grant | Counselor | 1617 Fountain Vw, Charlotte, NC 28203-5829 | 2020-06-24 |
| 1164046728 | Kevin Thomas Egroff | Counselor | 2134 Augusta St, Charlotte, NC 28216-4603 | 2020-05-29 |
| 1861039729 | No Bounds Care Inc of Nc | Counselor | 615 E 6th St Ste 102, Charlotte, NC 28202-2918 | 2019-12-10 |
| 1174168850 | Stress Management, LLC | Counselor | 8915 Legacy Park Dr Apt C, Charlotte, NC 28269-9622 | 2019-11-17 |
| 1154964062 | Setfreesoldiers, Inc | Counselor | 4900 Providence Rd, Charlotte, NC 28226-5848 | 2019-10-23 |
| 1083256762 | Speak Life Counseling Services, Pllc | Counselor | 16147 Lacaster Hwy, Suite 110, Charlotte, NC 28277 | 2019-10-14 |
| 1518508340 | Modern Era Counseling, Pllc | Counselor | 5200 Park Rd Ste 218-d, Charlotte, NC 28209-3650 | 2019-10-02 |
| Find all providers in CHARLOTTE | ||||
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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.