MEDICARE: NICOLE YVETTE MOORE LCAS-A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	LCAS-30607	NC
2	101YM0800X	Mental Health Counselor	A21731	NC

General Provider Information

NPI Number	:	1457924052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE YVETTE MOORE LCAS-A

Provider Business Mailing Address
First Line	:	301 N ELM ST STE 638
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27401-2083
Country	:	US
Telephone Number	:	336-662-7724
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 N ELM ST STE 638
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27401-2083
Country	:	US
Telephone Number	:	336-662-7724
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2021
Last Update Date	:	05/15/2026

Similar Medicare Providers

1710818190 — TYMEOUT COUNSELING AND CONSULTING SERVICES, LLC
Practice Location Address:

301 N ELM ST STE 638
GREENSBORO, NC
27401-2083

Practice Phone: 336-762-7071
Practice Fax:

1861570749 — MS. ALYCE L. BITTICKS NCC, LPCS, ACS
Practice Location Address:

301 N ELM ST
GREENSBORO, NC
27401-2083

Practice Phone: 336-274-1237
Practice Fax:

1699831503 — MS. SUSAN ROSS SHOEMAKER LPC-S, NCC, ACS
Practice Location Address:

301 N ELM ST , #801
GREENSBORO, NC
27401-2083

Practice Phone: 336-790-1119
Practice Fax: 336-274-1236

1154488203 — MRS. LINDA WILLIAMS GRENINGER NURSE PRACTITIONER
Practice Location Address:

301 N ELM ST
GREENSBORO, NC
27401-2083

Practice Phone: 336-274-1237
Practice Fax: 336-335-5710

1558595892 — EVA LEWIS WASHINGTON ET AL PTR
Practice Location Address:

301 N ELM ST , SUITE 510
GREENSBORO, NC
27401-2083

Practice Phone: 336-275-7973
Practice Fax: 336-272-1325

1619287190 — GREEN LIGHT COUNSELING, INC.
Practice Location Address:

301 N ELM ST , STE 801
GREENSBORO, NC
27401-2083

Practice Phone: 336-274-1237
Practice Fax: 336-274-1236

Directions to “ NICOLE YVETTE MOORE LCAS-A” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.