Katherine Renee Moore, LPCC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.0900160-S Issued in OH

Practice address

1659 South Breiel Blvd
Middletown, OH 45044-6705

Phone

(513) 424-0921

Fax

(513) 424-4810

NPI assigned

Feb 14, 2012

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

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Mental Health Counselor

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Counseling Source IncGroup PAC ID 6709772387, 51 clinicians

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.

• Counseling Source Inc

  • Mental Health Counselor
  • Blue Ash, OH
  • NPI 1639438518
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1376816819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1659 SOUTH BREIEL BLVD",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "45044",
            "telephone_number": "513-424-0921",
            "fax_number": "513-424-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1659 SOUTH BREIEL BLVD",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450446705",
            "telephone_number": "513-424-0921",
            "fax_number": "513-424-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KATHERINE",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "LPCC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-14",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.0900160-S",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Pappas Mollica, MSSA, LSW
• Momentum Provider Services LLC
• Heather N Moon, LPN
• Chelsea Marie Moore
• Danette Moore, P.T.
• Stephen R Moore, MD
• Norman Morales, PMHNP-BC
• Michelle S. Moran, SLP
• More Like Family, LLC
• Iris L Morgan, LPN

• Professional Counselor in Middletown, OH
• Providers in Middletown, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; 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.