Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1891554317 Individual Practitioner Male Practitioner

Phillip Moore , MA LPC-IT, SAC-IT

Counselor - Professional • Milwaukee, WI

Professional Overview & Biography Verified Profile Summary

Phillip Moore, MA LPC-IT, SAC-IT is a registered healthcare professional specializing in Counselor - Professional in Milwaukee, WI. Practice services are available at 11414 W PARK PL STE 202 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

11414 W Park Pl Ste 202

Milwaukee, WI 532243500

Telephone 9202046668
Associated Practice Facility / Clinic
🏢 Golden Touch Assisted Living Facility NPI 1801234109

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Milwaukee, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 12.1 Yrs
State Avg: 12.8 Yrs
Regional Practice Density
500 Specialists

Practicing in Milwaukee, WI (4511 Statewide)

Telehealth Adoption Rate
2.2% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-03-17
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License WI 7610-226

Definition to come...

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

State License WI 20136-130

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

21 Associated Practitioners
Perry Hennessy , APNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1023808672

Advanced Practice Nurse Prescriber

Diana Basler , HIS

Hearing Instrument Specialist

NPI 1053978841
Dyresha Whiteside , REGISTERED NURSE

Registered Nurse - Home Health

NPI 1235534744

REGISTEREDNURSE

Amanda Zheng , PA-C

Physician Assistant

NPI 1235771742

Physician Assistant (Certified)

Payton Metz

Social Worker - Clinical

NPI 1295325553
Laura Harfst

Social Worker - Clinical

NPI 1316454887

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active March 18, 2024

NPI status registered as active in NPPES database

📍
Updated Practice Location March 18, 2024

Registered at 11414 W PARK PL STE 202, MILWAUKEE, WI 532243500 (Tel: 9202046668)

📍
Updated Business Mailing Address March 18, 2024

Registered at 11414 W PARK PL STE 202, MILWAUKEE, WI 532243500 (Tel: 9202046668)

👤
Provider Name / Credentials Updated March 18, 2024

Recorded as PHILLIP MOORE, MA LPC-IT, SAC-IT

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 18, 2024

Counselor (License #20136-130 in WI)

🟢
Initial NPI Registration & Enumeration March 18, 2024

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1891554317
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 18, 2024
Last Update: March 18, 2024
Sole Proprietor: Yes

Mailing Address

11414 W Park Pl Ste 202

Milwaukee, WI 532243500

Phone: 9202046668

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.