Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Charles N Moore Jr., DMIN

Individual provider Clinical Psychologist · NPI 1104988500

Dr. Charles N Moore Jr., DMIN is a Clinical Psychologist in Essex, Massachusetts. Qualified in 1974, 52 years ago. Practices with Supportive Behavioral Care of MA LLC, a 106-clinician group and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
52
Licensed in
MA
In the registry since
2006
Specialties on file
4

Practice location Address checks out

23 Spring St
Essex, MA 01929-1311
Phone: (978) 884-8641
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Psychologist (primary) Taxonomy 103TF0000X · Licence 2097 (MA)
Clinical Psychologist Taxonomy 103TC0700X · Licence 2097 (MA)
Forensic Psychologist Taxonomy 103TF0200X · Licence 2097 (MA)
Psychologist Taxonomy 103T00000X · Licence 2097 (MA)

Record details

NPI number1104988500
Entity typeIndividual (Type 1)
GenderMale
Credentials DMIN
Sole proprietorYes
NPI enumeratedDecember 14, 2006
Last updated in NPPESSeptember 11, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1974 (52 years in practice)
Group practice Supportive Behavioral Care Of Ma Llc — 106 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Essex