NICOLE MOODY (NPI# 1457831901) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1457831901 |
Entity Type | Individual |
Full Name | NICOLE MOODY |
Credential | LMFT |
Practice Address |
620 Erie Blvd W Ste 208 Syracuse NY 13204-2457 |
Practice Telephone | 3154727363 |
Practice Fax Number | 3157012368 |
Mailing Telephone | 3154727363 |
Mailing Fax Number | 3157012368 |
Enumeration Date | 2018-08-15 |
Last Update Date | 2020-02-06 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101Y00000X | Counselor | P12131 | NY | Behavioral Health & Social Service Providers |
Y | 106H00000X | Marriage & Family Therapist | 001645 | NY | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | 1336163963 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104244391 | Nicole Moody | Social Worker | 913 W Holmes Rd, Suite 227, Lansing, MI 48910-0426 | 2014-04-03 |
Street Address |
620 ERIE BLVD W STE 208 |
City | SYRACUSE |
State | NY |
Zip Code | 13204-2457 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477873776 | Lorna Cordella Forbes | Registered Nurse | 620 Erie Blvd W Ste 208, Syracuse, NY 13204 | 2010-06-09 |
1811596968 | Breanna Teresa Mcintyre | Social Worker | 620 Erie Blvd W Ste 208, Syracuse, NY 13204-2457 | 2020-10-20 |
1881293116 | Elizabeth Houston | Social Worker | 620 Erie Blvd W Ste 208, Syracuse, NY 13204-2457 | 2020-10-19 |
1992303630 | Crystal Houston | Marriage & Family Therapist | 620 Erie Blvd W Ste 208, Syracuse, NY 13204-2457 | 2020-10-14 |
1659913853 | Amanda Marie Horth | Counselor | 620 Erie Blvd W Ste 208, Syracuse, NY 13204-2457 | 2019-10-09 |
1033775408 | Ashley Michelle Price | Nurse Practitioner | 620 Erie Blvd W Ste 208, Syracuse, NY 13204-2457 | 2019-05-11 |
1538630173 | Cody Patrick Campbell | Social Worker | 620 Erie Blvd W Ste 208, Syracuse, NY 13204-2457 | 2018-12-07 |
1497252563 | Onondaga Case Management Services Inc. | Clinic/Center | 620 Erie Blvd W Ste 208, Syracuse, NY 13204-2457 | 2018-04-06 |
1669988788 | Joann Daucher | Licensed Practical Nurse | 620 Erie Blvd W Ste 208, Syracuse, NY 13204-2457 | 2017-12-27 |
1538672860 | Jixuan Zhao | Social Worker | 620 Erie Blvd W Ste 208, Syracuse, NY 13204-2457 | 2017-11-08 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417560145 | Angela Hester | Psychologist | Behavioral Health Outpatient Clinic, 620 Erie Blvd West, Syracuse, NY 13204 | 2020-08-24 |
1366967366 | Zakiya Folami Moss | Nurse Practitioner | 321 Gifford Street, Syracuse, NY 13204 | 2017-08-10 |
1417350497 | Vickie Godbold | Licensed Practical Nurse | 501 Bellevue Ave, Syracuse, NY 13204 | 2014-10-03 |
1700296571 | Christine Michelle Feliciano | Licensed Practical Nurse | 206 Merriman Ave, Syracuse, NY 13204 | 2014-05-02 |
1215358213 | Mika Latoy Johnson | Licensed Practical Nurse | 197 Lakeview Ave, Syracuse, NY 13204 | 2013-12-18 |
1376834374 | Autumn Day Novakowski | Registered Nurse | 800 S. Wilbur Ave, Syracuse, NY 13204 | 2011-04-25 |
1649580440 | Elizabeth Elliott Carl | Speech-Language Pathologist | 204 Jamesville Road, Dewitt, NY 13204 | 2010-10-14 |
1699082073 | Charlene Davis | Licensed Practical Nurse | 183 Lakeview Ave., Syr, NY 13204 | 2010-09-08 |
1043442528 | Juliet Ophelia Williams-seals | Licensed Practical Nurse | 525 Plum St, Apt 404, Syracuse, NY 13204 | 2009-08-17 |
1164667754 | Jessica Gabrielle Peppe | Speech-Language Pathologist | 1744 West Genesee Street, Syracuse, NY 13204 | 2008-12-10 |
Find all providers in zip 13204 |
Taxonomy Code | 106H00000X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Marriage & Family Therapist |
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134752454 | Crystal Elizabeth Hoban | Marriage & Family Therapist | 4922 W. Seneca Turnpike, Syracuse, NY 13215 | 2020-02-14 |
1891327540 | Ashley Kessler | Marriage & Family Therapist | 2122 Erie Blvd E Ste C, Syracuse, NY 13224-1041 | 2020-02-11 |
1275193641 | Jennifer Whang | Marriage & Family Therapist | 677 S Salina St, Syracuse, NY 13202-3535 | 2019-06-18 |
1134789563 | Mind, Body & Spirit Marriage and Family Therapy | Marriage & Family Therapist | 825 Northway St, Syracuse, NY 13224-1322 | 2019-06-18 |
1801453147 | Kaylea Dineen | Marriage & Family Therapist | 677 S Salina St Ste 200, Syracuse, NY 13202-3513 | 2019-05-22 |
1821583436 | Jacqueline Amanda Weiner | Marriage & Family Therapist | 3532 James Street, Syracuse, NY 13206 | 2018-06-26 |
1083107106 | Georgia Hicks | Marriage & Family Therapist | 414 Hawley Ave # 2, Syracuse, NY 13203-2410 | 2018-06-13 |
1356893903 | Donna Dallal-ferne | Marriage & Family Therapist | 312 Hampshire Dr, Syracuse, NY 13214-1507 | 2016-10-31 |
1992162705 | Breyanna Marie Locke | Marriage & Family Therapist | 50 Presidential Plz Ste Ll4, Syracuse, NY 13202-2229 | 2016-01-25 |
1639568967 | Roberto De Giorgio | Marriage & Family Therapist | 1723 W 1375 S, Syracuse, UT 84075-6951 | 2015-01-09 |
Find all providers in SYRACUSE |
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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.