MS. QUEENIE MAE MOORE NPI 1669656484

NPI Information

  • NPI: 1669656484
  • Provider Name: MS. QUEENIE MAE MOORE
  • Classification: Counselor - 101Y00000X
  • Entity Type: Individual
  • Address: 1415 STATE ST
    NEW HAVEN, CT
    ZIP 06511
  • Phone: (203) 691-1038

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NPI Details

MS. Queenie Mae Moore is a counselor in New Haven, CT. The provider is 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. MS. Queenie Mae Moore NPI is 1669656484. 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:

1415 STATE ST
NEW HAVEN, CT
ZIP 06511-702
Phone: (203) 691-1038
Fax: (203) 691-1038

The enumeration date for this NPI number is 12/28/2007 and was last updated on 12/28/2007.

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
1101Y00000XCounselor000755CONNECTICUTYes

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: 11/21/2025

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