Individual provider Active NPI

Patricia F Moura, LMHC, LPC

  • Mental Health Counselor
  • Summerville, SC
National Provider Identifier
1184222796
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
9406 Issued in SC
Practice address
105 S Cedar St
Summerville, SC 29483-6078
Phone
(854) 855-2167
NPI assigned
Oct 15, 2020
Last updated
Aug 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 10001235 MA
Mental Health Counselor 101YM0800X 9406 SC Primary

Addresses

Primary practice location

105 S Cedar St
Summerville, SC 29483-6078

Mailing address

105 S Cedar St
Summerville, SC 29483-6078
Phone (854) 855-2167

Other identifiers 1

IdentifierTypeStateIssuer
435201MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10001235MAMDMental Health Counselor
9406SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mindset Counseling and Coaching, LLC CurrentSince Jan 5, 2025 Accepting new patients
Berkeley Community Mental Health Center PastSince Sep 1, 2021 Accepting new patients
South Carolina Dept of Mental Health Accounting Office PastSince Sep 1, 2021 Accepting new patients

Locations

105 S Cedar St
Summerville, SC 29483
Phone (843) 212-6543

Organizations & group practices 3

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": "1602720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1184222796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S CEDAR ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836078",
            "telephone_number": "854-855-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S CEDAR ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836078",
            "telephone_number": "854-855-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOURA",
        "first_name": "PATRICIA",
        "middle_name": "F",
        "credential": "LMHC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-15",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "10001235",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "9406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "435201",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.