Individual provider Active NPI

Mark Moorman II

  • Counselor
  • Xenia, OH
National Provider Identifier
1053564138
Registry record updated Nov 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
C0701172TRNE Issued in OH
Practice address
452 W Market St
Xenia, OH 45385-2815
Phone
(937) 376-8700
NPI assigned
Nov 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X C0701172TRNE OH Primary

Addresses

Primary practice location

452 W Market St
Xenia, OH 45385-2815

Mailing address

452 W Market St
Xenia, OH 45385-2815
Phone (937) 376-8700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240415003586 OH Practitioner - Mental Health Counselor 3173962735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TCN Behavioral Health Services, Inc.Group PAC ID 8224011135, 20 clinicians

Practice addresses (Care Compare)

452 W Market St
Xenia, OH 45385-2815
Phone (937) 376-8700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C0701172TRNEOHMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
TCN Behavioral Health Services, Inc. CurrentSince Feb 28, 2024 Accepting new patients

Locations

452 W Market St
Xenia, OH 45385
Phone (937) 376-8744

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225670400000",
    "number": "1053564138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 W MARKET ST",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453852815",
            "telephone_number": "937-376-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 W MARKET ST",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453852815",
            "telephone_number": "937-376-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORMAN",
        "first_name": "MARK",
        "name_suffix": "II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-03",
        "last_updated": "2008-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C0701172TRNE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Xenia, OH

Sources for this page

Verify at the official NPI Registry.