Dr. Benjamin Luther Moore , PhD
Psychologist - Clinical • Bloomington, IL
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Benjamin Moore has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dr. Benjamin Moore, PhD was a registered Psychologist - Clinical practicing in Bloomington, IL. Throughout an active medical career spanning 10 years, Dr. Moore provided care at the practice location at 105 N REGENCY DR until profile deactivation on 2017-11-13.
Practice Location & Contact Primary Location
105 N Regency Dr
Bloomington, IL 617013515
Specialty Benchmarks & Practice Insights
Comparative analytics for Psychologist - Clinical in Bloomington, IL
Practicing in Bloomington, IL (4140 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 103TC0700X
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Dentist - General Practice
Doctor of Dental Surgery
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on November 13, 2017
NPI status registered as active in NPPES database
Registered at 105 N REGENCY DR, BLOOMINGTON, IL 617013515 (Tel: 3096638272)
Registered at 105 N REGENCY DR, BLOOMINGTON, IL 617013515 (Tel: 3096638272)
Recorded as BENJAMIN MOORE, PH.D.
Psychologist
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
105 N Regency Dr
Bloomington, IL 617013515
Phone: 3096638272
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