Individual provider Active NPI

Derrica Moser, CT

  • Counselor
  • Columbus, OH
National Provider Identifier
1326637802
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
C.2002945-TRNE Issued in OH
Practice address
195 N Grant Ave Ste 250
Columbus, OH 43215-2855
Phone
(440) 260-8300
NPI assigned
Jan 11, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X C.2002945-TRNE OH Primary

Addresses

Primary practice location

195 N Grant Ave Ste 250
Columbus, OH 43215-2855

Mailing address

434 Eastland Rd
Berea, OH 44017-1217
Phone (440) 234-2006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20251209001479 OR Practitioner - Mental Health Counselor 8820582729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Project QuestGroup PAC ID 3971490970, 7 clinicians

Practice addresses (Care Compare)

3231 SE 50TH Ave
Portland, OR 97206-2248
Phone (503) 238-5203

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.2002945-TRNEOHMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Project Quest CurrentSince Nov 12, 2025 Accepting new patients
Project Quest Past Accepting new patients

Locations

3231 SE 50th Ave
Portland, OR 97206
Phone (503) 775-0861

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1326637802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 EASTLAND RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171217",
            "telephone_number": "440-234-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 N GRANT AVE STE 250",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432152855",
            "telephone_number": "440-260-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSER",
        "first_name": "DERRICA",
        "credential": "CT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C.2002945-TRNE",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.