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

Stacy Moore

Individual provider Professional Counselor · NPI 1457285389

Stacy Moore is a Mental Health Counselor in San Antonio, Texas. Qualified in 2024, 2 years ago. Licensed in Texas.

Years since qualifying
2
Licensed in
TX
In the registry since
2026
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Practice location Address checks out

1777 NE Loop 410 Ste 825
San Antonio, TX 78217-5248
Phone: (214) 530-0021
Fax: (214) 530-0021
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 95637 (TX)

Record details

NPI number1457285389
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 8, 2026
Last updated in NPPESJune 8, 2026
Certification dateJune 8, 2026

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated

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