PENNY MOORE (NPI# 1891208344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891208344 |
| Entity Type | Individual |
| Full Name | PENNY MOORE |
| Credential | LCDC |
| Practice Address |
2266 Wakefield Mound Rd Piketon OH 45661 |
| Mailing Address |
3243 Dry Run Rd West Portsmouth OH 45663-9069 |
| Practice Telephone | 7409611092 |
| Enumeration Date | 2017-11-07 |
| Last Update Date | 2019-07-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
131001 | OH | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
QMHS | OH | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 411 Court St, Portsmouth, OH 456623932 | 7403546685 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124475249 | Penny Moore | Counselor | 150 Cross St, Akron, OH 44311-1026 | 2016-05-18 |
| Street Address |
2266 WAKEFIELD MOUND RD |
| City | PIKETON |
| State | OH |
| Zip Code | 45661 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639728769 | Terrill Lewis | Counselor | 2266 Wakefield Mound Rd, Piketon, OH 45661-9660 | 2019-09-11 |
| 1326695610 | Stephen Edward Wallingford | Counselor | 2266 Wakefield Mound Rd, Piketon, OH 45661-9660 | 2019-08-21 |
| 1285106195 | Melissa Joy Lopez | Counselor | 2266 Wakefield Mound Rd, Piketon, OH 45661-9660 | 2018-12-18 |
| 1275004392 | Gary Davis | Counselor | 2266 Wakefield Mound Rd, Piketon, OH 45661-9660 | 2018-12-16 |
| 1861982910 | Staci Huston | Counselor | 2266 Wakefield Mound Rd, Piketon, OH 45661-9660 | 2018-05-15 |
| 1679063721 | Heath Jones | Counselor | 2266 Wakefield Mound Rd, Piketon, OH 45661-9660 | 2018-05-15 |
| 1659861706 | Erica Hickman | Counselor | 2266 Wakefield Mound Rd, Piketon, OH 45661-9660 | 2018-05-15 |
| 1235628801 | Corey Summers | Counselor | 2266 Wakefield Mound Rd, Piketon, OH 45661-9660 | 2018-05-09 |
| 1487143012 | Angela F Pemberton | Counselor | 2266 Wakefield Mound Rd, Piketon, OH 45661-9660 | 2018-05-09 |
| 1144735572 | Jason Daniel Rhodes | Counselor | 2266 Wakefield Mound Rd, Piketon, OH 45661-9660 | 2017-12-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649882028 | Quest Diagnostics | Clinical Medical Laboratory | 7777 St Rt 23, Ste A, Piketon, OH 45661 | 2020-08-18 |
| 1497303614 | Johnny Conley | Counselor | 15521 State Route 772, Piketon, OH 45661 | 2019-08-30 |
| 1538657622 | Brewsters Hometown Pharmacy LLC | Pharmacy | 104 Thornton Dr, Piketon, OH 45661 | 2018-04-25 |
| 1205349891 | Amanda Riggs | Counselor | 15221 State Route 124, Piketon, OH 45661 | 2017-11-06 |
| 1811409899 | Lydia R Jenkins | Counselor | 15221 St. Rt. 124, Piketon, OH 45661 | 2017-10-30 |
| 1912443730 | Lee Adams | Counselor | 15221 St Rt 124, Piketon, OH 45661 | 2017-01-18 |
| 1558729806 | Pleasant Hill Leasing, LLC | Skilled Nursing Facility | 7143 Us Route 23 South, Piketon, OH 45661 | 2016-02-02 |
| 1750758892 | David Conley | Nurse Practitioner | 418 Skyline Dr, Piketon, OH 45661 | 2015-08-24 |
| 1558597724 | Sarah E. Williams | Dental Hygienist | 7777 U.S. Route 23, Piketon, OH 45661 | 2009-06-02 |
| 1205073327 | Pike Co | Ambulance | 109 Oliver Street, Piketon, OH 45661 | 2009-01-12 |
| Find all providers in zip 45661 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497303614 | Johnny Conley | Counselor | 15521 State Route 772, Piketon, OH 45661 | 2019-08-30 |
| 1205349891 | Amanda Riggs | Counselor | 15221 State Route 124, Piketon, OH 45661 | 2017-11-06 |
| 1811409899 | Lydia R Jenkins | Counselor | 15221 St. Rt. 124, Piketon, OH 45661 | 2017-10-30 |
| 1205355393 | Michelle Rana Colley | Counselor | 15221 State Route 772, Piketon, OH 45661-9062 | 2017-09-11 |
| 1912443730 | Lee Adams | Counselor | 15221 St Rt 124, Piketon, OH 45661 | 2017-01-18 |
| 1255946554 | Robert Hurles | Counselor | 15221 State Route 772, Piketon, OH 45661-9062 | 2020-09-14 |
| 1114550050 | Benjamin Glispie | Counselor | 15221 St Rt 124, Piketon, OH 45661 | 2020-02-19 |
| 1366089302 | Amber Self | Counselor | 15221 St Rt 124, Piketon, OH 45661 | 2019-12-10 |
| 1053957878 | David Bryan Porter Jr. | Counselor | 15221 State Route 772, Piketon, OH 45661-9062 | 2019-11-27 |
| 1740826890 | Mason Conley | Counselor | 15221 State Route 772, Piketon, OH 45661-9062 | 2019-11-25 |
| Find all providers in PIKETON | ||||
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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.