CONNIE JUNG MOORE PHD, LPC
NPI 1902840960
Counselor - Professional in Guthrie, OK

Active since June 16, 2006
12352 SPRING CIR, GUTHRIE, OK 73044(405) 473-3453 Get Directions Write a Review

NPPES record last updated: September 19, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Connie Jung Moore Phd, Lpc NPPES

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

CONNIE JUNG MOORE PHD, LPC (NPI 1902840960) is an individual professional provider in Guthrie, Oklahoma, licensed in Oklahoma (3379) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1902840960
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameCONNIE JUNG MOORECredential: PHD, LPC
Location Address12352 SPRING CIRGuthrie, OK 73044-9772
Mailing Address12352 Spring CirGuthrie, OK 73044-9772 · (405) 473-3453
Sole ProprietorYes
Enumeration DateJune 16, 2006
Last NPPES UpdateSeptember 19, 2025
NPPES CertifiedSeptember 19, 2025
NPI 1902840960 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License Licensed in OK · 3379
12352 SPRING CIR, Guthrie, OK 73044

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Connie Jung Moore Phd, Lpc 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 February 5, 2024 through February 5, 2026.

Opt-Out Effective DateFebruary 5, 2024
Opt-Out In Effect ThroughFebruary 5, 2026Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1902840960, enumerated as an "individual" on June 16, 2006.

The provider is located at 12352 SPRING CIR GUTHRIE, OK 73044 and the phone number is (405) 473-3453.

Counselor with taxonomy code 101YP2500X and a focus in Professional.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Oklahoma, Medica,. Please consult your insurance carrier or call the provider to verify.