Latrease R Moore, LMHC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

024435-01 Issued in NY

Practice address

1612 Genesee St
Utica, NY 13502-5425

Phone

(315) 724-5173

NPI assigned

Feb 11, 2016

Last updated

Dec 1, 2021By the provider in NPPES

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 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Samaritan Counseling Center of the Mohawk Valley, Inc

  • Mental Health Counselor
  • Utica, NY
  • NPI 1649377854
  Medicare reassignment NPD
• K & M Wellness, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rome, NY
  • NPI 1013696012

  Clinical

  NPD Authorized official
• Premier Counseling and Psychological Services

  • Clinical Psychologist
  • Rome, NY
  • NPI 1245998798

  Mental Health

  NPD Authorized official
• Samaritan Counseling Center of the Mohawk Valley, Inc

  • Social Worker
  • Utica, NY
  • NPI 1588903454
  NPD (past)

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

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1497114920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025425",
            "telephone_number": "315-724-5173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025425",
            "telephone_number": "315-724-5173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LATREASE",
        "middle_name": "R",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-11",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "005071",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "024435-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eh Moo
• Ashley Moody, DC
• Donna Moon
• Sarah Christine Mooney, FNP
• Ann G Moore, PT
• Hamid Moosavi, M.D.
• Nataly Mor, MD
• Beatrice Morea, MD
• Myron Clinton Morgan Jr., DDS
• Sandra Moriarity

• Clinical Psychologist in Utica, NY
• Providers in Utica, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.