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

Jason Edward Moore

Individual provider Mental Health Counselor · NPI 1043979479

Jason Edward Moore is a Mental Health Counselor in South Lake Tahoe, California. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
2

Practice location Address checks out

1900 Lake Tahoe Blvd
South Lake Tahoe, CA 96150-6305
Phone: (530) 573-7970
Show map & directions

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

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X
Mental Health Counselor Taxonomy 101YM0800X

Record details

NPI number1043979479
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 13, 2021
Last updated in NPPESJune 24, 2024
Certification dateJune 24, 2024

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