Mary Kelly Moore Lackey, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC04635 Issued in OK

Practice address

4013 NW Expressway Ste 105
Oklahoma City, OK 73116-2618

Phone

(405) 378-2727

NPI assigned

Jun 30, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Specialty

Mental Health Counselor

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

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.

• Balance Women'S Health, LLC

  • Clinical Psychologist
  • Moore, OK
  • NPI 1790186385
  Medicare reassignment NPD
• Oklahoma Mental Health Council

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oklahoma City, OK
  • NPI 1275574907
  Medicare reassignment NPD
• Oklahoma Mental Health Council

  • Community/Behavioral Health Agency
  • Hobart, OK
  • NPI 1801219340
  NPD
• Oklahoma Mental Health Council

  • Community/Behavioral Health Agency
  • Clinton, OK
  • NPI 1649793746
  NPD (past)

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1326200437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4013 NW EXPRESSWAY STE 105",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731162618",
            "telephone_number": "405-378-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4013 NW EXPRESSWAY STE 105",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731162618",
            "telephone_number": "405-378-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE LACKEY",
        "first_name": "MARY",
        "middle_name": "KELLY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-30",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "LPC04635",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "LPC04635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard J Mooney, MD
• Moonlight Anesthesia Consulting Inc
• Amal E Moorad, M.D.
• Moore Chiropractic PC
• Moore Dentistry & Braces
• Moore Restored, Inc
• Tamesha Burnnett Moore-Adams
• Abby Moore
• Adam Moore, DDS
• Alexis Nicole Moore

• Professional Counselor in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Professional Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.