Bredell Keith Moody, LCMHCA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

A13082 Issued in NC

Practice address

7850 Brier Creek Pkwy Ste 102
Raleigh, NC 27617-8900

Phone

(919) 748-4878

Fax

(919) 748-4876

NPI assigned

Apr 21, 2021

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Avance Care, PA

  • Clinic/Center
  • Fuquay Varina, NC
  • NPI 1487845020
  NPD

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1700467685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 WORLD TRADE BLVD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276174202",
            "telephone_number": "919-237-1337",
            "fax_number": "866-538-4716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7850 BRIER CREEK PKWY STE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276178900",
            "telephone_number": "919-748-4878",
            "fax_number": "919-748-4876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "BREDELL",
        "middle_name": "KEITH",
        "credential": "LCMHCA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A13082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Schmidling Montgomery, LCSW
• Caroline Montz
• Nicholas C Monu, MD
• Moods and Affects PLLC
• Amanda Leigh Moody, PMHNP
• Mary Frances Moody, MD
• Shawn Ryan Moody, DPT
• Abigail Mook, MS
• Michele Peil Moonan, RPH
• Kacy Mooney

• Professional Counselor in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.