Individual provider Active NPI

Kamren Moose, LCAS, LCSWA

  • Addiction (Substance Use Disorder) Counselor
  • Concord, NC
National Provider Identifier
1730627936
Registry record updated Jan 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LCAS-29681 Issued in NC
Practice address
284 Executive Park Dr Ste 100
Concord, NC 28025-1833
Phone
(704) 939-1100
Fax
(704) 939-1173
NPI assigned
Feb 8, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P020259 NC
Addiction (Substance Use Disorder) Counselor 101YA0400X LCAS-29681 NC Primary

Addresses

Primary practice location

284 Executive Park Dr Ste 100
Concord, NC 28025-1833

Mailing address

284 Executive Park Dr Ste 100
Concord, NC 28025-1833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20250806004004 NC Practitioner - Mental Health Counselor 6204358260 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCAS-29681NCMDAddiction (Substance Use Disorder) Counselor
P020259NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brightview LLC CurrentSince Jun 30, 2025 Accepting new patients

Locations

341 N Fayetteville St
Asheboro, NC 27203
Phone (336) 629-8896

311 Hill St
Murphy, NC 28906
Phone (828) 835-2420

1930 Jake Alexander Blvd W
Salisbury, NC 28147

4600 Montgomery Rd
Ste 400
Cincinnati, OH 45212
Phone (513) 873-1269

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769126400000",
    "number": "1730627936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 EXECUTIVE PARK DR STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "284 EXECUTIVE PARK DR STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251833",
            "telephone_number": "704-939-1100",
            "fax_number": "704-939-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOSE",
        "first_name": "KAMREN",
        "credential": "LCAS, LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-08",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P020259",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-29681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.