Mary G Moore , LCPC
Counselor • Normal, 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, Mary Moore has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Mary Moore, LCPC was a registered Counselor practicing in Normal, IL. Throughout an active medical career spanning 14 years, Mary Moore provided care at the practice location at 103 WILLIAM DR until profile deactivation on 2023-01-25.
Practice Location & Contact Primary Location
103 William Dr
Normal, IL 617611862
Specialty Benchmarks & Practice Insights
Comparative analytics for Counselor in Normal, IL
Practicing in Normal, IL (3897 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 101Y00000X
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on January 25, 2023
NPI status registered as active in NPPES database
Registered at 103 WILLIAM DR, NORMAL, IL 617611862 (Tel: 3094521473)
Registered at 103 WILLIAM DR, NORMAL, IL 617611862 (Tel: 3094521473)
Recorded as MARY MOORE, L.C.P.C.
Counselor (License #180000847 in IL)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
103 William Dr
Normal, IL 617611862
Phone: 3094521473
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