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Deactivated NPI 1235282104 Deactivated / Inactive NPI Male Practitioner

Dr. Charles Moore , PhD

Psychologist • Whitehall, WI

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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. Charles Moore has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 22, 2007
NPI Deactivation Date January 30, 2020
Total Practice Duration ~13 Years of Practice (2007 – 2020)

Professional Overview & Biography Verified Profile Summary

Dr. Charles Moore, PhD was a registered Psychologist practicing in Whitehall, WI. Throughout an active medical career spanning 13 years, Dr. Moore provided care at the practice location at W20298 STATE ROAD 121 until profile deactivation on 2020-01-30.

Practice Location & Contact Primary Location

Practice Address

W20298 State Road 121

Whitehall, WI 547739685

Telephone 7152842831
Fax 7152842832
Associated Practice Facility / Clinic
🏢 County Of Trempealeau Facility NPI 1346208931

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Whitehall, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 22.4 Yrs
Regional Practice Density
2 Specialists

Practicing in Whitehall, WI (1000 Statewide)

Telehealth Adoption Rate
0.0% 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

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License WI 1028-057

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Practice Associates & Co-Workers

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

1 Associated Practitioners
Nicholas Lee

Counselor - Addiction (Substance Use Disorder)

NPI 1275685422

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated January 30, 2020

Record deactivated on January 30, 2020

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at W20298 STATE ROAD 121, WHITEHALL, WI 547739685 (Tel: 7152842831)

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Updated Business Mailing Address July 08, 2007

Registered at W20298 STATE ROAD 121, WHITEHALL, WI 547739685 (Tel: 7152842831)

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Provider Name / Credentials Updated July 08, 2007

Recorded as CHARLES MOORE, PHD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Psychologist (License #1028-057 in WI)

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Initial NPI Registration & Enumeration January 22, 2007

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: 1235282104
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 22, 2007
Last Update: July 08, 2007
Deactivation Date: January 30, 2020

Mailing Address

W20298 State Road 121

Whitehall, WI 547739685

Phone: 7152842831

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.