NPIMap

Organization Active NPI

Keep Moving Forward Counseling & Consulting LLC

  • Mental Health Counselor
  • Dayton, OH
National Provider Identifier
1174925762
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E3509 Issued in OH
Legal business name
KEEP MOVING FORWARD COUNSELING & CONSULTING LLC
Practice address
515 Windsor Park Dr
Dayton, OH 45459-4112
Phone
(937) 723-9881
Fax
(937) 723-9881
NPI assigned
Sep 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Authorized official

Name
Mr. Brent Alan BernardNPI 1700287901
Title
Owner
Phone
(513) 312-1532

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X E3509 OH
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X E3509 OH Primary

Addresses

Primary practice location

515 Windsor Park Dr
Dayton, OH 45459-4112

Mailing address

515 Windsor Park Dr
Dayton, OH 45459-4112
Phone (937) 723-9881

Other practice location 1

99 S Main Street
Centerville, OH 45458-2367
Phone (937) 723-9881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190304002195 OH Part B Supplier - Clinic/Group Practice 1658610936 Receives reassigned benefits from 6 practitioners
Practice locations: Dayton, OH

National Provider Directory

National Provider Directory

Locations

99 S Main St
Centerville, OH 45458
Phone (513) 312-1532

515 Windsor Park Dr
Dayton, OH 45459
Phone (937) 723-9881

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1411603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702252800000",
    "number": "1174925762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 WINDSOR PARK DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454594112",
            "telephone_number": "937-723-9881",
            "fax_number": "937-723-9881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 WINDSOR PARK DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454594112",
            "telephone_number": "937-723-9881",
            "fax_number": "937-723-9881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "99 S MAIN STREET",
            "address_purpose": "LOCATION",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454582367",
            "country_code": "US",
            "telephone_number": "937-723-9881",
            "fax_number": "937-723-9881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KEEP MOVING FORWARD COUNSELING & CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-25",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A",
        "authorized_official_last_name": "BERNARD",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "513-312-1532",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "E3509",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E3509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.