K & M Wellness, Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

K & M WELLNESS, INC

Practice address

#186 Mohawk Acres Plaza
1756 Black River Blvd
Rome, NY 13440

Phone

(315) 220-0603

NPI assigned

Jul 17, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Latrease R Moore, PHDNPI 1497114920

Title

Co-Owner

Phone

(315) 220-0603

Specialties & licenses 4

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Latrease R Moore, LMHC

  • Clinical Psychologist
  • Utica, NY
  • NPI 1497114920
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690416000000",
    "number": "1013696012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "#186 MOHAWK ACRES PLAZA",
            "address_2": "1756 BLACK RIVER BLVD",
            "city": "ROME",
            "state": "NY",
            "postal_code": "13440",
            "telephone_number": "315-220-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#186 MOHAWK ACRES PLAZA",
            "address_2": "1756 BLACK RIVER BLVD",
            "city": "ROME",
            "state": "NY",
            "postal_code": "13440",
            "telephone_number": "315-220-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K & M WELLNESS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "LATREASE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "315-220-0603",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph F Femia MD PC
• Maree Joy
• Shayla Jubis, DPT
• Gursimrat K Judge, DDS
• Just Breathe Yoga Studio, Inc
• Jody Karas, P.T,,D.P.T.
• Richard P Kaskiw, MD
• Jennifer Kegebein
• Nicole Dmitri Kekis, P.T.
• Michael R Kelly

• Mental Health Clinic/Center (Including Community Mental Health Center) in Rome, NY
• Providers in Rome, NY by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.