Kendra Moultrie-Belk, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.013808 Issued in IL

Practice address

2139 SW Adams St
Peoria, IL 61602-1801

Phone

(309) 453-6257

NPI assigned

Sep 4, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  IL, Professional

  Medicare reassignment NPD
• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  IL, Professional

  Medicare reassignment NPD
• Healing Through Words PLLC

  • Professional Counselor
  • Peoria, IL
  • NPI 1639096852
  NPD (past) Authorized official

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

{
    "created_epoch": "1630713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1316615255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2139 SW ADAMS ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2139 SW ADAMS ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021801",
            "telephone_number": "309-453-6257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULTRIE-BELK",
        "first_name": "KENDRA",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-04",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.013808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "180.013808",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miranda Taylor Morton
• Mosaic
• Colleen Moser, PT
• Gregory T Moskop, MD
• Gregory John Motzkus, DO
• Michele Lynn Mounce, CNP
• Cameron Mouro, M.D.
• Erin Elizabeth Mowers, MD, PHD
• Megan N Mowery, APRN, CNP
• Julie D Moza, DEVL THERAPIST

• Professional Counselor in Peoria, IL
• Providers in Peoria, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.