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EBONY STAR BAKER-MOORE EDD,LPC,MFT
NPI 1467897728
Counselor - Professional in Douglasville, GA

Active since May 01, 2013PECOS Enrolled
316 ALEXANDER STREET, SUITE 2, DOUGLASVILLE, GA 30134(404) 597-9910(888) 908-7984 Get Directions Write a Review

NPPES record last updated: December 18, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 18, 2025, Sep 21, 2021 (2 updates tracked since 2021).

About Ebony Star Baker-moore Edd,lpc,mft NPPES

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

EBONY STAR BAKER-MOORE EDD,LPC,MFT (NPI 1467897728) is an individual professional provider in Douglasville, Georgia, licensed in Georgia (LPC007289) and active in the NPI registry since May 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1467897728
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameEBONY STAR BAKER-MOORECredential: EDD,LPC,MFT
Location Address316 ALEXANDER STREET, SUITE 2Douglasville, GA 30134-7205
Mailing Address3486 Mckown RdDouglasville, GA 30134-2812 · (404) 597-9910 · Fax (888) 908-7984
Phone(404) 597-9910
Fax(888) 908-7984
Sole ProprietorYes
Medical School CMSOtherGraduated 2006
Enumeration DateMay 1, 2013
Last NPPES UpdateDecember 18, 20252 updates tracked since enumeration
NPPES CertifiedDecember 18, 2025
✔ NPI 1467897728 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in GA · LPC007289
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License LPC007289 (GA)
316 ALEXANDER STREET, Douglasville, GA 30134
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ebony Star Baker-moore Edd,lpc,mft is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5395221956
PECOS Enrollment IDI20260113003485
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.

Medicare Billing Reassignment

Medicare enrollment records show Ebony Baker-moore reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grady Memorial Hospital Corporation
21 mi
Multi-Specialty
3896 PRINCETON LAKES WAY
Atlanta, GA 30331
  • Reassigned Medicare billing, Georgia enrollment
  • 771 clinicians in this Medicare group
NPI 1649765686 (404) 616-8880

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Ebony Baker-moore's NPI number?

The NPI number for Ebony Baker-moore is 1467897728. It was assigned to this individual provider in the NPPES registry on May 1, 2013.

Where is Ebony Baker-moore located?

Ebony Baker-moore practices at 316 Alexander Street Suite 2, Douglasville, GA 30134. The listed phone number is (404) 597-9910.

What is Ebony Baker-moore's specialty?

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

Is Ebony Baker-moore enrolled in Medicare?

Yes. Ebony Baker-moore is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ebony Baker-moore's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ebony Baker-moore reassigns Medicare benefits to Grady Memorial Hospital Corporation (Atlanta, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ebony Baker-moore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Ebony Baker-moore was last updated on December 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.