Odetta Maria Moore, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC06275 Issued in OK

Practice address

5310 E 31St St
Tulsa, OK 74135-5018

Phone

(918) 600-3100

Fax

(918) 560-1399

NPI assigned

Oct 6, 2011

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 OK

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

Telehealth

Offers telehealth services

Group practices

Homecare Advisors LLCGroup PAC ID 3173877362, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Homecare Advisors LLC

  dba Pinnacle Care

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Durant, OK
  • NPI 1689152894
  Medicare reassignment Care Compare group NPD
• Mind & Heart Therapy, LLC

  • Professional Counselor
  • Tulsa, OK
  • NPI 1568072965
  Medicare reassignment NPD Authorized official
• Laureate Psychiatric Clinic and Hospital Inc

  • Psychiatric Hospital
  • Tulsa, OK
  • NPI 1710985064
  Medicare reassignment NPD

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

{
    "created_epoch": "1317859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1689958894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 701111",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741701111",
            "telephone_number": "918-406-7195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 E 31ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741355018",
            "telephone_number": "918-600-3100",
            "fax_number": "918-560-1399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6655 S Yale Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741363326",
            "country_code": "US",
            "telephone_number": "918-491-3700",
            "fax_number": "918-481-4063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ODETTA",
        "middle_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-06",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "LPC06275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa L Moore, DPT
• Meloney Ellen Moore
• Micaylon Moore
• Michael Shane Moore Jr., DO
• Natalie Nicole Moore, M.S. CCC-SLP
• Payton Cheyanne Moore
• Quanah Moore
• Rebecca Nichole Moore, APRN-CNP
• Robert Wade Moore
• Rodger Allen Moore, HIS, HADF

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.