Individual provider Active NPI

Kathleen Moran

  • Mental Health Counselor
  • Latham, NY
National Provider Identifier
1477297117
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
6 Wellness Way Ste 112
Latham, NY 12110-2142
Phone
(518) 881-1109
NPI assigned
Apr 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

6 Wellness Way Ste 112
Latham, NY 12110-2142

Mailing address

6 Wellness Way Ste 201
Latham, NY 12110-2156
Phone (518) 782-3700

Other names 1

  • Katie Moran Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250407002831 NY Practitioner - Mental Health Counselor 9436673811 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
Telehealth
Offers telehealth services
Group practices
Community Care Physicians PLLCGroup PAC ID 8022904473, 361 clinicians

Practice addresses (Care Compare)

6 Wellness Way
Latham, NY 12110-2156
Phone (518) 782-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015828NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Physicians, PLLC CurrentSince Feb 28, 2025 Accepting new patients
Community Care Physicians, PLLC Mental Health CurrentSince Apr 6, 2025 Accepting new patients

Locations

713 Troy Schenectady Rd
Latham, NY 12110
Phone (518) 262-4942

6 Wellness Way
Ste 112
Latham, NY 12110
Phone (518) 881-1109

711 Troy Schenectady Rd
Ste 210
Latham, NY 12110

6 Wellness Way
Ste 201
Latham, NY 12110
Phone (518) 782-3900

6 Wellness Way
Latham, NY 12110
Phone (518) 881-1109

Interoperability endpoints

  • Direct secure messaging: kathleenmoran@ccp.allscriptsdirect.net

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": "1651017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1477297117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 201",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102156",
            "telephone_number": "518-782-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 WELLNESS WAY STE 112",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102142",
            "telephone_number": "518-881-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-27",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "MORAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Latham, NY

Sources for this page

Verify at the official NPI Registry.