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MS. R. JACQUELINE MOORE M.ED., LMHC, NCC
NPI 1265683197
Counselor - Mental Health in Ellensburg, WA

Active since October 09, 2008Opted out of Medicare · through Jan 1, 2028
109 E 3RD AVE STE 5, ELLENSBURG, WA 98926(509) 620-6753 Get Directions Write a Review

NPPES record last updated: November 9, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ms. R. Jacqueline Moore M.ed., Lmhc, Ncc NPPES

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

MS. R. JACQUELINE MOORE M.ED., LMHC, NCC (NPI 1265683197) is an individual mental health provider in Ellensburg, Washington, licensed in Washington (LH00007112) and active in the NPI registry since October 2008. She has opted out of Medicare through January 1, 2028.

NPPES Registry Identity

NPI1265683197
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMS. R. JACQUELINE MOORECredential: M.ED., LMHC, NCC
Location Address109 E 3RD AVE STE 5Ellensburg, WA 98926-3357
Mailing AddressPo Box 403Ellensburg, WA 98926-1914 · (509) 620-6753
Phone(509) 620-6753
Sole ProprietorNo
Enumeration DateOctober 9, 2008
Last NPPES UpdateNovember 9, 2023
NPPES CertifiedNovember 9, 2023
✔ NPI 1265683197 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in WA · LH00007112
109 E 3RD AVE STE 5, Ellensburg, WA 98926
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Ms. R. Jacqueline Moore M.ed., Lmhc, Ncc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2024
Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is R. Moore's NPI number?

The NPI number for R. Moore is 1265683197. It was assigned to this individual provider in the NPPES registry on October 9, 2008.

Where is R. Moore located?

R. Moore practices at 109 E 3rd Ave Ste 5, Ellensburg, WA 98926. The listed phone number is (509) 620-6753.

What is R. Moore's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is R. Moore enrolled in Medicare?

No. R. Moore has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for R. Moore was last updated on November 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.