Charles Moody, LPC
Counselor, Professional in Jonesboro, AR. Individual provider (NPI-1).
NPI number1679693261
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1679693261
- Entity type
- Individual (NPI-1)
- Name
- Charles Moody
- Credential
- LPC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 29, 2007
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | P0412053 | AR | Yes |
Practice location
2707 Browns LnJonesboro, AR 72401-7213
Phone 870-972-4939 · Fax 870-972-4911
Mailing address
2707 Browns LnJonesboro, AR 72401-7213
Phone 870-972-4939 · Fax 870-972-4911
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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