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General NPI Number Information
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NPI Number | 1376333658
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Entity Type | Individual
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Provider Name | CHARRA MONYAE MOORE
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Gender | Female
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Dates
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Enumeration Date | 05/09/2025
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 184 FRONT AVE
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City | WEST HAVEN
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State | CT
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Zip | 06516-2836
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Country | US
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Telephone | 203-781-4600
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Fax | 203-781-4624
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Provider Business Mailing Address
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Address Line | 740 MIX AVE UNIT 403
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City | HAMDEN
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State | CT
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Zip | 06514-2286
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Country | US
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Telephone | 475-321-6717
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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