Mr Timothy Howard Moore, LPC | |
3040 N University Ave, Suite 2, Decatur, IL 62526-1391 | |
(217) 872-1700 | |
(217) 872-1366 |
Full Name | Mr Timothy Howard Moore |
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Gender | Male |
Speciality | Counselor |
Location | 3040 N University Ave, Decatur, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144494881 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | (Illinois) | Primary |
Entity Name | Decatur Psychological Associates Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1184732745 PECOS PAC ID: 2466452602 Enrollment ID: O20070111000292 |
Mailing Address | Practice Location Address |
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Mr Timothy Howard Moore, LPC 3040 N University Ave, Suite 2, Decatur, IL 62526-1391 Ph: (217) 872-1700 | Mr Timothy Howard Moore, LPC 3040 N University Ave, Suite 2, Decatur, IL 62526-1391 Ph: (217) 872-1700 |
Carrie A Ray, Counselor Medicare: Medicare Enrolled Practice Location: 151 N Main St, Decatur, IL 62523 Phone: 217-362-6262 | |
Robert Lesley Goodwin, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 320 E Central Ave, Decatur, IL 62521 Phone: 217-877-9117 | |
Ms. Linda L Warden-michl, MA, NCC, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 132 S Water St, Suite 630, Decatur, IL 62523 Phone: 217-330-6963 | |
Michelle Hanson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 151 N Main St, Decatur, IL 62523 Phone: 217-362-6262 Fax: 217-362-6290 | |
Lesa J Mcmahon-lowe, LPC Counselor Medicare: Medicare Enrolled Practice Location: 151 N Main St, Decatur, IL 62523 Phone: 217-420-4776 Fax: 217-362-6259 | |
Marilyn Stevens, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 363 S Main St, Suite 220, Decatur, IL 62523 Phone: 217-638-5545 Fax: 217-424-1633 | |
Kelly Thurston, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 151 N Main St, Decatur, IL 62523 Phone: 217-362-6262 Fax: 217-362-6290 |