KENETRA DEVONNE MOORE (NPI# 1407263593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407263593 |
| Entity Type | Individual |
| Full Name | KENETRA DEVONNE MOORE |
| Other Name | K DEVONNE MOORE |
| Credential | LCAS, CCS |
| Practice Address |
3815 N Tryon St Charlotte NC 28206-2060 |
| Mailing Address |
1923 J N Pease Pl Ste 104 Charlotte NC 28262-4534 |
| Practice Telephone | 7043728890 |
| Mailing Telephone | 7049001850 |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2019-08-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 21286 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 284 Executive Park Dr, Suite 100, Concord, NC 280251831 | 7049391100 | |
| 8401 Medical Plaza Dr Ste 360, Charlotte, NC 282628700 | 7042084458 |
| Street Address |
3815 N TRYON ST |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28206-2060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154545663 | Hope Haven Inc | Community/Behavioral Health | 3815 N Tryon St, Charlotte, NC 28206-2060 | 2007-04-13 |
| 1073176665 | Flay Lee | Counselor | 3815 N Tryon St, Charlotte, NC 28206-2060 | 2019-04-18 |
| 1669035267 | Tina Lathan Boyer | Counselor | 3815 N Tryon St, Charlotte, NC 28206-2060 | 2019-04-18 |
| 1063075034 | Salvatore Pryor | Counselor | 3815 N Tryon St, Charlotte, NC 28206-2060 | 2019-04-16 |
| 1285197657 | Lewis Scott Carter | Counselor | 3815 N Tryon St, Charlotte, NC 28206-2060 | 2019-04-11 |
| 1962965350 | Linsey Patterson | Counselor | 3815 N Tryon St, Charlotte, NC 28206-2060 | 2019-04-11 |
| 1316400948 | Charles Hayward Samuels Jr. | Counselor | 3815 N Tryon St, Charlotte, NC 28206-2060 | 2019-04-10 |
| 1679036578 | Synovia Pettice | Counselor | 3815 N Tryon St, Charlotte, NC 28206-2060 | 2019-04-09 |
| 1528474509 | Khysha Le Wise | Counselor | 3815 N Tryon St, Charlotte, NC 28206-2060 | 2014-07-10 |
| 1780962993 | Felicia Gail Thrasher | Counselor | 3815 N Tryon St, Charlotte, NC 28206-2060 | 2011-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861019150 | Novant Medical Group, Inc. | Family Medicine | 2701 Statesville Ave., Charlotte, NC 28206 | 2020-07-02 |
| 1609433291 | Life Interrupted Counseling Services | Counselor | 4045 N Tryon St Ste A, Charlotte, NC 28206 | 2019-05-20 |
| 1295141216 | Taqiyah Camyah Barber | Prosthetic/Orthotic Supplier | 3829 Perennial Terrace Dr, #g, Charlotte, NC 28206 | 2014-07-10 |
| 1386976033 | Olugboyega Remi Fisher | Community Health Worker | 1801 N.tryon Street, Suiteb114, Charlotte, NC 28206 | 2010-02-05 |
| 1821225699 | Alzenia Kelly Morris | Counselor | 1801 N Tryon Street Ste 339, Charlotte, NC 28206 | 2009-06-18 |
| 1942479936 | American Current Care of North Carolina PC | Clinic/Center | 2835 Jeff Adams Drive, Suite A, Charlotte, NC 28206 | 2008-02-25 |
| 1992823629 | Shari J Baum | Preventive Medicine | 2830 North I-85, Suite A and B, Charlotte, NC 28206 | 2007-03-27 |
| 1255479135 | Tameka Denise Jenkins | Counselor | 1600 Norris Ave., Charlotte, NC 28206 | 2007-02-02 |
| 1871655803 | Dwight Hollier | Counselor | 1801 North Tryon Street, Suite 309, Charlotte, NC 28206 | 2006-12-15 |
| 1093213621 | Mishelle L Lockerby | Counselor | 5108 Reagan Dr, Charlotte, NC 28206 | 2018-01-29 |
| Find all providers in zip 28206 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619574829 | Steve Hanna Interventions | Counselor | 8101 Providence Court Ln Apt 101, Charlotte, NC 28270-2385 | 2020-10-01 |
| 1164036976 | Diamond Corbin | Counselor | 3553 N Sharon Amity Rd Ste 200, Charlotte, NC 28205-8992 | 2020-08-31 |
| 1366053035 | Triumph Therapeutic Services Pllc | Counselor | 620 Parkaire Ln Apt 1024, Charlotte, NC 28217-2492 | 2020-08-14 |
| 1407472582 | Sarah Ann Grant | Counselor | 1617 Fountain Vw, Charlotte, NC 28203-5829 | 2020-06-24 |
| 1164046728 | Kevin Thomas Egroff | Counselor | 2134 Augusta St, Charlotte, NC 28216-4603 | 2020-05-29 |
| 1861039729 | No Bounds Care Inc of Nc | Counselor | 615 E 6th St Ste 102, Charlotte, NC 28202-2918 | 2019-12-10 |
| 1174168850 | Stress Management, LLC | Counselor | 8915 Legacy Park Dr Apt C, Charlotte, NC 28269-9622 | 2019-11-17 |
| 1154964062 | Setfreesoldiers, Inc | Counselor | 4900 Providence Rd, Charlotte, NC 28226-5848 | 2019-10-23 |
| 1083256762 | Speak Life Counseling Services, Pllc | Counselor | 16147 Lacaster Hwy, Suite 110, Charlotte, NC 28277 | 2019-10-14 |
| 1518508340 | Modern Era Counseling, Pllc | Counselor | 5200 Park Rd Ste 218-d, Charlotte, NC 28209-3650 | 2019-10-02 |
| Find all providers in CHARLOTTE | ||||
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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.