Individual provider Active NPI

Pamela Moreno, LPC

  • Mental Health Counselor
  • Phoenix, AZ
National Provider Identifier
1306540372
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC23300 Issued in AZ
Practice address
4131 N 24TH St Ste B102
Phoenix, AZ 85016-6231
Phone
(480) 882-4545
Fax
(602) 903-7091
NPI assigned
Mar 27, 2023
Last updated
May 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LAC-13775 AZ
Mental Health Counselor 101YM0800X LPC23300 AZ Primary

Addresses

Primary practice location

4131 N 24TH St Ste B102
Phoenix, AZ 85016-6231

Mailing address

7500 N Dreamy Draw Dr Ste 145
Phoenix, AZ 85020-4668
Phone (480) 882-4545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20241204000988 AZ Practitioner - Mental Health Counselor 8426584269 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LAC-13775AZMDCounselor
LPC23300AZMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Outreach Access to Health CurrentSince Nov 20, 2024 Accepting new patients
Neighborhood Outreach Access to Health Mental Health CurrentSince Nov 20, 2024 Accepting new patients

Locations

11851 N 51st Ave
Ste B110
Glendale, AZ 85304

11851 N 51st Ave
Ste F140
Glendale, AZ 85304
Phone (623) 428-0001

16251 N Cave Creek Rd
Phoenix, AZ 85032

20440 N 27th Ave
Phoenix, AZ 85027

4131 N 24th St
Ste B102
Phoenix, AZ 85016
Phone (602) 955-6632

7500 N Dreamy Draw Dr
Ste 145
Phoenix, AZ 85020

9015 N 3rd St
Phoenix, AZ 85020

8705 E McDowell Rd
Scottsdale, AZ 85257

Organizations & group practices 2

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": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1306540372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 N DREAMY DRAW DR STE 145",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204668",
            "telephone_number": "480-882-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 N 24TH ST STE B102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850166231",
            "telephone_number": "480-882-4545",
            "fax_number": "602-903-7091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "PAMELA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AZ",
            "license": "LAC-13775",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC23300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.