Individual provider Active NPI

Rebecca Lynn Moorman, LPCC

  • Professional Counselor
  • Owensboro, KY
National Provider Identifier
1073618658
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
102124 Issued in KY
Practice address
2211 Mayfair Dr Ste 409
Owensboro, KY 42301-4570
Phone
(270) 417-7980
Fax
(270) 417-7989
NPI assigned
Sep 14, 2006
Last updated
Nov 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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 102124 KY Primary
Professional Counselor 101YP2500X 0591 KY

Addresses

Primary practice location

2211 Mayfair Dr Ste 409
Owensboro, KY 42301-4570

Mailing address

PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 688-1330

Other practice location 1

57 Dora Ln
Greenup, KY 41144-1187
Phone (606) 473-7333

Other identifiers 1

IdentifierTypeStateIssuer
30610026MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20240123002495 KY Practitioner - Mental Health Counselor 1850743055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2211 Mayfair Dr
Suite 409
Owensboro, KY 42301-4570
Phone (270) 417-7980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0591KYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group, Inc Professional CurrentSince Jan 1, 2024 Accepting new patients
Owensboro Health Medical Group Inc Current Accepting new patients
Owensboro Health Medical Group Inc CurrentSince Jan 1, 2024 Accepting new patients
Pathways, Inc Past Accepting new patients
Pathways Inc Past Accepting new patients

Locations

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

2211 Mayfair Dr
Ste 409
Owensboro, KY 42301
Phone (270) 417-7980

2025 W Everly Brothers Blvd
Ste 1A
Powderly, KY 42367
Phone (270) 377-2600

Interoperability endpoints

  • Direct secure messaging: rmoorman100332@direct.owensborohealth.org

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1073618658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23229",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423043229",
            "telephone_number": "270-688-1330",
            "fax_number": "270-688-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 MAYFAIR DR STE 409",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423014570",
            "telephone_number": "270-417-7980",
            "fax_number": "270-417-7989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "57 Dora Ln",
            "address_purpose": "LOCATION",
            "city": "Greenup",
            "state": "KY",
            "postal_code": "411441187",
            "country_code": "US",
            "telephone_number": "606-473-7333",
            "fax_number": "606-473-7335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORMAN",
        "first_name": "REBECCA",
        "middle_name": "LYNN",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "102124",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "0591",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30610026",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.