1. Home
  2. Directory
  3. Maryland
  4. Rosedale
  5. Counselor
  6. NPI Profile

SHANNON MOORE
NPI 1912439001
Counselor - Professional in Rosedale, MD

Active since March 29, 2017PECOS Enrolled
9627 PHILADELPHIA RD STE 160, ROSEDALE, MD 21237(410) 780-5203(410) 780-5205 Get Directions Write a Review

NPPES record last updated: September 15, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 15, 2025, Mar 17, 2018, Mar 29, 2017 (3 updates tracked since 2017).

About Shannon Moore NPPES

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

SHANNON MOORE (NPI 1912439001) is an individual professional provider in Rosedale, Maryland, licensed in Maryland (16339) and active in the NPI registry since March 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1912439001
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameSHANNON MOORE
Location Address9627 PHILADELPHIA RD STE 160Rosedale, MD 21237-4157
Mailing Address9627 Philadelphia Rd Ste 160Rosedale, MD 21237-4157 · (410) 780-5203 · Fax (410) 780-5205
Phone(410) 780-5203
Fax(410) 780-5205
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateMarch 29, 2017
Last NPPES UpdateSeptember 15, 20253 updates tracked since enumeration
NPPES CertifiedSeptember 15, 2025
✔ NPI 1912439001 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 MD · 16339
Also ListedRehabilitation PractitionerTaxonomy 225400000X
9627 PHILADELPHIA RD STE 160, Rosedale, MD 21237
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

PECOS PAC ID2062997414
PECOS Enrollment IDI20260402002715
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.

LONNETTE MCPHERSON
Counselor (Mental Health)
9627 PHILADELPHIA RD STE 160
ROSEDALE, MD 21237
Baltimore County (443) 469-5138
ADRIAN LEE STACKHOUSE
Social Worker (Clinical)
9627 PHILADELPHIA RD STE 160
ROSEDALE, MD 21237
Baltimore County (410) 780-5203
AMBER DUKES LGPC
Counselor (Mental Health)
9627 PHILADELPHIA RD STE 160
ROSEDALE, MD 21237
Baltimore County (410) 780-5203
AYREL J FUNDERBURK
Social Worker
9627 PHILADELPHIA RD STE 160
ROSEDALE, MD 21237
Baltimore County (410) 780-5203
ABBIGALE ELIZABETH BOEHL
Counselor (Mental Health)
9627 PHILADELPHIA RD STE 160
ROSEDALE, MD 21237
Baltimore County (410) 780-5203
CAROLINE ELIZABETH MOLLENAUER
Social Worker
9627 PHILADELPHIA RD STE 160
ROSEDALE, MD 21237
Baltimore County (410) 780-5203
GRACE OMENYI LGPC
Counselor (Mental Health)
9627 PHILADELPHIA RD STE 160
ROSEDALE, MD 21237
Baltimore County (410) 780-5203
IESHA KENYETTE FELTON LCPC
Counselor (Professional)
9627 PHILADELPHIA RD STE 160
ROSEDALE, MD 21237
Baltimore County (410) 780-5203

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 Shannon Moore's NPI number?

The NPI number for Shannon Moore is 1912439001. It was assigned to this individual provider in the NPPES registry on March 29, 2017.

Where is Shannon Moore located?

Shannon Moore practices at 9627 Philadelphia Rd Ste 160, Rosedale, MD 21237. The listed phone number is (410) 780-5203.

What is Shannon Moore's specialty?

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

Is Shannon Moore enrolled in Medicare?

Yes. Shannon Moore is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shannon Moore was last updated on September 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.