MS. GENNEA NICKOLE MOORE (NPI# 1043458516) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043458516 |
| Entity Type | Individual |
| Full Name | MS. GENNEA NICKOLE MOORE |
| Credential | LLP |
| Practice Address |
18303 E 10 Mile Rd Roseville MI 48066-4988 |
| Mailing Address |
22524 Schroeder Ave Eastpointe MI 48021-4010 |
| Practice Telephone | 2484699519 |
| Mailing Telephone | 2484699519 |
| Enumeration Date | 2009-01-21 |
| Last Update Date | 2019-06-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 6301013299 | MI | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
6301013299 | MI | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 22708 Harper Ave, Saint Clair Shores, MI 480801823 | 5862643692 |
| Street Address |
18303 E 10 MILE RD |
| City | ROSEVILLE |
| State | MI |
| Zip Code | 48066-4988 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255337689 | Joel C Engel | Internal Medicine | 18303 E 10 Mile Rd, Suite 100, Roseville, MI 48066-4988 | 2005-06-21 |
| 1962888354 | Pacharee Kulwattanaporn | Dentist | 18303 E 10 Mile Rd, Suite 150, Roseville, MI 48066-4988 | 2015-08-07 |
| 1578990339 | Elizabeth Smith | Social Worker | 18303 E 10 Mile Rd, Roseville, MI 48066-4988 | 2013-10-10 |
| 1740625524 | Lydia Joy Rayes | Family Medicine | 18303 E 10 Mile Rd, Suite 500, Roseville, MI 48066-4988 | 2013-05-07 |
| 1477733756 | Paul Campbell Do PC | Family Medicine | 18303 E 10 Mile Rd, Roseville, MI 48066-4988 | 2007-11-05 |
| 1477754323 | Ali H Shakir | Internal Medicine | 18303 E 10 Mile Rd, Suite 100, Roseville, MI 48066-4988 | 2007-05-29 |
| 1679783344 | Bobak Taher Rabbani | Internal Medicine | 18303 E 10 Mile Rd, Suite 100, Roseville, MI 48066-4988 | 2007-05-23 |
| 1154350890 | Cardiovascular Institute of Michigan, P.C. | Internal Medicine | 18303 E 10 Mile Rd, Suite 100, Roseville, MI 48066-4988 | 2006-07-03 |
| 1194765305 | Edward Fitzpatrick | Dentist | 18303 E 10 Mile Rd, Suite 150, Roseville, MI 48066-4988 | 2006-06-07 |
| 1902853021 | Endodontic Associates | Dentist | 18303 E 10 Mile Rd, Roseville, MI 48066-4988 | 2006-05-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437761400 | Louay Mansour Dds PC | Dentist | 27845 Gratiot Avenue, Roseville, MI 48066 | 2020-08-20 |
| 1558911842 | Jomy Jose | Nurse Practitioner | 25719 Salem St, Roseville, MI 48066 | 2019-09-18 |
| 1053963033 | Convenient Rv PC | Dentist | 19551 E. 10 Mile Rd, Roseville, MI 48066 | 2019-07-10 |
| 1063914539 | Colleen Meriweather | Registered Nurse | 27300 Spruce, Rosevilel, MI 48066 | 2018-03-01 |
| 1326565789 | Renee Suzette Hoelzeman | Nurse Practitioner | 18472 Meier St, Roseville, MI 48066 | 2017-08-27 |
| 1225561400 | Eugenia Dillard | Counselor | 28351 Gratiot Ave., Suite 3, Roseville, MI 48066 | 2017-04-05 |
| 1932651338 | Julie Plichota | Physical Therapist | 31120 Gratiot Ave, Roseville, MI 48066 | 2016-11-01 |
| 1699221325 | Jaquenta Glasker | Technician, Other | 26778 Rosewood, Roseville, MI 48066 | 2016-09-01 |
| 1609296144 | Peter Jajou | Dermatology | 18285 E 10 Mile Rd Ste 130, Roseville, MI 48066 | 2014-04-23 |
| 1619393899 | Katherine Michelle Johnson | Obstetrics & Gynecology | 29751 Little Mack Ave Ste B, Roseville, MI 48066 | 2014-03-11 |
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| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902370505 | Diverse Assessments and Treatment, LLC | Psychologist | 1935 Cty Rd B2 W Ste 270, Roseville, MN 55113 | 2019-01-16 |
| 1477918654 | William Hayward Staso | Psychologist | 2137 Rhodes Ln, Roseville, CA 95747-9024 | 2015-12-15 |
| 1073773651 | John Honebrink | Psychologist | 1700 W Hwy 36, 210 Rosedale Towers, Roseville, MN 55113 | 2008-06-17 |
| 1063610004 | Chassity Angeny-showalter | Psychologist | 1741 E Roseville Pkwy, Suite 200, Roseville, CA 95661-6449 | 2007-07-10 |
| 1932321486 | Thanh Son Thi Nguyen-kelly | Psychologist | 1315 West Larpenteur Suite I, Roseville, MN 55113 | 2007-05-03 |
| 1073669313 | Albert and Associates | Psychologist | 1700 Highway 36 W, Suite 516, Roseville, MN 55113-4034 | 2007-01-27 |
| 1922151596 | Mardelle Brandt Pearson | Psychologist | 2172 Midland View Ct N, Roseville, MN 55113-5304 | 2007-01-18 |
| 1689737694 | Gloria S Simard | Psychologist | 406 Sunrise Ave Ste 220, Roseville, CA 95661-4100 | 2006-12-19 |
| 1568521524 | Margaret L Mcchesney | Psychologist | 3025 Simpson St, Roseville, MN 55113-1650 | 2006-12-06 |
| 1962580951 | John M. Kendra | Psychologist | 2130 Professional Dr Ste 220, Roseville, CA 95661-3780 | 2006-11-01 |
| Find all providers in ROSEVILLE | ||||
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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.