MARISSA MOORE LPCC
NPI 1073027678
Counselor - Professional in Sandusky, OH

Q: What is Marissa Moore's NPI number?

The NPI number for Marissa Moore is 1073027678. It was assigned to this individual provider in the NPPES registry on November 20, 2017.

Q: What is Marissa Moore's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Marissa Moore was last updated on December 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 20, 2017PECOS Enrolled

1925 HAYES AVE, SANDUSKY, OH 44870(419) 557-5177 Get Directions Write a Review

NPPES record last updated: December 14, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 14, 2020, Aug 15, 2018, Nov 20, 2017 (3 updates tracked since 2017).

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About Marissa Moore Lpcc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARISSA MOORE LPCC (NPI 1073027678) is an individual professional provider in Sandusky, Ohio, licensed in Ohio (E.2001980) and active in the NPI registry since November 2017. She is enrolled in Medicare PECOS and maintains a secondary practice location in Cleveland.

NPPES Registry Identity

NPI1073027678

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameMARISSA MOORECredential: LPCC

Location Address1925 HAYES AVESandusky, OH 44870

Mailing Address1925 Hayes AveSandusky, OH 44870-4737 · (419) 557-5177

Phone(419) 557-5177

Sole ProprietorNo

Enumeration DateNovember 20, 2017

Last NPPES UpdateDecember 14, 20203 updates tracked since enumeration

NPPES CertifiedDecember 14, 2020

✔ NPI 1073027678 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in OH · E.2001980

Also ListedCounselorTaxonomy 101Y00000X · License C.1700197 (OH)

Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X · License CDCA.150752 (OH)

1925 HAYES AVE, Sandusky, OH 44870

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Secondary Practice Location 1

Location 17901 Detroit AveCleveland, OH 44102-2828 · Phone (216) 634-7500

Other Identifiers 1

Medicaid3293725OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, MedMutual.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marissa Moore Lpcc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. ADA M BLOOM LISW

Social Worker (Clinical)