Individual provider Active NPI

Alicia L Venus, PHD, ABPP-CN

  • Clinical Neuropsychologist
  • Moore, OK
National Provider Identifier
1144603945
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Practice address
1044 SW 4TH St
Moore, OK 73160-2405
Phone
(405) 735-6333
Fax
(405) 735-6629
NPI assigned
Jun 30, 2015
Last updated
Apr 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X Primary

Addresses

Primary practice location

1044 SW 4TH St
Moore, OK 73160-2405

Mailing address

1044 SW 4TH St
Moore, OK 73160-2405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180409001745 MA Practitioner - Clinical Psychologist 8123381928
I20230531001856 OK Practitioner - Clinical Psychologist 8123381928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moore Counseling Center, P.C.Group PAC ID 9436151511, 5 clinicians

Practice addresses (Care Compare)

1044 SW 4TH St
Moore, OK 73160-2405
Phone (405) 735-6333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Moore Counseling Center, P.C. CurrentSince May 3, 2023 Accepting new patients

Locations

1044 SW 4th St
Moore, OK 73160
Phone (405) 735-6333

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, 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": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1144603945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 SW 4TH ST",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 SW 4TH ST",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602405",
            "telephone_number": "405-735-6333",
            "fax_number": "405-735-6629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENUS",
        "first_name": "ALICIA",
        "middle_name": "L",
        "credential": "PHD, ABPP-CN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-30",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moore, OK

Sources for this page

Verify at the official NPI Registry.