Individual provider Active NPI

Kasey Moore, LMHC

  • Mental Health Counselor
  • Pensacola, FL
National Provider Identifier
1912694969
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH22071 Issued in FL
Practice address
7100 Plantation Rd Ste 2
Pensacola, FL 32504-6234
Phone
(850) 775-7591
NPI assigned
Apr 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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 MH22071 FL Primary

Addresses

Primary practice location

7100 Plantation Rd Ste 2
Pensacola, FL 32504-6234

Mailing address

7100 Plantation Rd Ste 2
Pensacola, FL 32504-6234
Phone (850) 775-7591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20241017004499 FL Practitioner - Mental Health Counselor 3971035791 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bayou Wellness of Northwest Florida, LLCGroup PAC ID 4587085444, 6 clinicians

Practice addresses (Care Compare)

7100 Plantation Rd
Suite 2
Pensacola, FL 32504-6234
Phone (850) 324-7912

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH22071FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bayou Wellness of Northwest Florida, LLC CurrentSince Oct 8, 2024 Accepting new patients
Cotler Healthcare & Development Inc. CurrentSince Sep 25, 2024 Accepting new patients

Locations

901 S 62nd Ave
Hollywood, FL 33023
Phone (954) 893-0109

9835 Lake Worth Rd
Ste 16179
Lake Worth, FL 33467

7100 Plantation Rd
Ste 2
Pensacola, FL 32504
Phone (850) 324-7912

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": "1681948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1912694969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 PLANTATION RD STE 2",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325046234",
            "telephone_number": "850-775-7591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 PLANTATION RD STE 2",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325046234",
            "telephone_number": "850-775-7591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KASEY",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-20",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH22071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.