Provider Demographics
NPI:1992011357
Name:MOORE, JAMES W (BCBA-D)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:MOORE
Suffix:
Gender:M
Credentials:BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2075 E HONEYSUCKLE PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-2316
Mailing Address - Country:US
Mailing Address - Phone:602-463-2210
Mailing Address - Fax:
Practice Address - Street 1:670 N ARIZONA AVE STE 1
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-6742
Practice Address - Country:US
Practice Address - Phone:602-809-5083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-24
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBEH-001339103K00000X
1-02-0969103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst