Individual provider Active NPI

Cheri Lyn Cantrell-McCoy, LPC

  • Mental Health Counselor
  • Moore, OK
National Provider Identifier
1063718658
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC06788 Issued in OK
Practice address
1105 SW 30TH CT
Moore, OK 73160-2887
Phone
(405) 378-2727
NPI assigned
Jan 31, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC06788 OK
Mental Health Counselor 101YM0800X LPC06788 OK Primary

Addresses

Primary practice location

1105 SW 30TH CT
Moore, OK 73160-2887

Mailing address

1105 SW 30TH CT
Moore, OK 73160-2887
Phone (405) 378-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20250113000361 OK Practitioner - Mental Health Counselor 4789112293 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Balance Womens Health LLCGroup PAC ID 3476927740, 89 clinicians

Practice addresses (Care Compare)

1105 SW 30TH CT
Moore, OK 73160-2887
Phone (405) 378-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC06788OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Balance Women'S Health, LLC CurrentSince Dec 1, 2024 Accepting new patients

Locations

1105 SW 30th Ct
Ste B
Moore, OK 73160

1105 SW 30th Ct
Moore, OK 73160
Phone (405) 378-4439

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": "1296432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1063718658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SW 30TH CT",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602887",
            "telephone_number": "405-378-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 SW 30TH CT",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602887",
            "telephone_number": "405-378-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTRELL-MCCOY",
        "first_name": "CHERI",
        "middle_name": "LYN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-31",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "LPC06788",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "LPC06788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moore, OK

Sources for this page

Verify at the official NPI Registry.