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

Individual provider Marriage & Family Therapist · NPI 1386290054

Thora Elisebeth Lieby Moore is a Marriage and Family Therapist in Provo, Utah. Qualified in 2020, 6 years ago. Practices with Wasatch Behavioral Health Special Service District, a 82-clinician group and accepts Medicare assignment.

Years since qualifying
6
In the registry since
2019
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Practice location Address checks out

750 N Freedom Blvd
Provo, UT 84601-1677
Phone: (801) 373-4760
Fax: (801) 373-0639
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X

Record details

NPI number1386290054
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 17, 2019
Last updated in NPPESAugust 17, 2019

Medicare enrollment

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

Medicare specialtyMARRIAGE AND FAMILY THERAPIST
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Wasatch Behavioral Health Special Service District — 82 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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