IVONNE MOORE BA NPI 1619265832

NPI Information

NPI: 1619265832
Provider Name: IVONNE MOORE, BA
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
484 MAIN ST
SUITE 450
WORCESTER, MA
ZIP 01608
Phone: (508) 752-2590
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Ivonne Moore, BA is an addiction (substance use disorder) counselor in Worcester, MA. Ivonne Moore, BA NPI is 1619265832. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

484 MAIN ST
SUITE 450
WORCESTER, MA
ZIP 01608-893
Phone: (508) 752-2590
Fax: (508) 753-5051

The enumeration date for this NPI number is 7/21/2011 and was last updated on 7/21/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	Y10400	MEDICARE PIN	MASSACHUSETTS
2	1308785	MEDICAID	MASSACHUSETTS
3	22220002001	OTHER	MASSACHUSETTS	BLUE CROSS
4	M18684	OTHER	MASSACHUSETTS	BLUE CROSS
5	1306461	MEDICAID	MASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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