TRACEY MOORE
NPI 1184105090
Counselor in South Bend, IN

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101Y00000X.

Active since August 28, 2018

415 E MADISON ST, SOUTH BEND, IN 46617(574) 533-1234(574) 537-2652 Get Directions Write a Review

NPPES record last updated: August 28, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Tracey Moore NPPES

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

TRACEY MOORE (NPI 1184105090) is an individual counselor in South Bend, Indiana and active in the NPI registry since August 2018.

NPPES Registry Identity

NPI1184105090

Entity TypeIndividualFemale

Primary Taxonomy101Y00000X

Provider Legal NameTRACEY MOORE

Location Address415 E MADISON STSouth Bend, IN 46617-2322

Mailing Address330 Lakeview DrGoshen, IN 46528-7000 · (574) 533-1234 · Fax (574) 537-2652

Phone(574) 533-1234

Fax(574) 537-2652

Sole ProprietorNo

Enumeration DateAugust 28, 2018

✔ NPI 1184105090 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

Definition

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.

415 E MADISON ST, South Bend, IN 46617

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