TRACY J MOORE LCAS-A NPI 1558614677

NPI Information

NPI: 1558614677
Provider Name: TRACY J MOORE, LCAS-A
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
5500 EXECUTIVE CENTER DR
CHARLOTTE, NC
ZIP 28212
Phone: (704) 537-5760
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Tracy J Moore, LCAS-A is an addiction (substance use disorder) counselor in Charlotte, NC. Tracy J Moore, LCAS-A NPI is 1558614677. 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:

5500 EXECUTIVE CENTER DR
CHARLOTTE, NC
ZIP 28212-856
Phone: (704) 537-5760

The enumeration date for this NPI number is 10/26/2012 and was last updated on 9/28/2016.

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	1041C0700X	Social Worker	Clinical	P007403	NORTH CAROLINA	No
2	101YM0800X	Counselor	Mental Health	LCAS-15519	NORTH CAROLINA	No
3	171M00000X	Case Manager/Care Coordinator		LCAS-15519	NORTH CAROLINA	No
4	172V00000X	Community Health Worker		LCAS-15519	NORTH CAROLINA	No
5	101Y00000X	Counselor		LCAS-15519	NORTH CAROLINA	No
6	101YA0400X	Counselor	Addiction (Substance Use Disorder)	LCAS-15519	NORTH CAROLINA	Yes

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: 5/5/2024

NPI Synchronization or Removal

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