MOLLY PORT LPC
NPI 1124431101
Counselor - Professional in Lake Havasu City, AZ
About Molly Port Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MOLLY PORT LPC (NPI 1124431101) is an individual professional provider in Lake Havasu City, Arizona, licensed in Arizona (LPC-16468) and active in the NPI registry since June 2014. She is enrolled in Medicare PECOS and is a graduate of Other (2013).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Molly Port Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Molly Port reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Lake Havasu City, AZ 86403
- Reassigned Medicare billing, Arizona enrollment
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LAKE HAVASU CITY, AZ 86403
LAKE HAVASU CITY, AZ 86403
LAKE HAVASU CITY, AZ 86403
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Molly Port's NPI number?
The NPI number for Molly Port is 1124431101. It was assigned to this individual provider in the NPPES registry on June 6, 2014.
Where is Molly Port located?
Molly Port practices at 1930 Mesquite Ave Suite # 1A, Lake Havasu City, AZ 86403. The listed phone number is (928) 855-4900.
What is Molly Port's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Molly Port enrolled in Medicare?
Yes. Molly Port is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Molly Port's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Molly Port reassigns Medicare benefits to Azpen Counseling & Services, LLC (Lake Havasu City, AZ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Molly Port's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Molly Port accept?
Health plans from Blue Cross Blue Shield of Arizona list Molly Port as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Molly Port was last updated on August 30, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Molly Port, LPC · NPI 1124431101
Professional provider in Lake Havasu City, Arizona. Individual provider, active in the CMS NPPES registry since June 6, 2014.
## Identity
- **NPI:** 1124431101 (Entity type: Individual)
- **Enumerated:** June 6, 2014
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** LPC-16468 (Arizona)
- **Sole proprietor:** No
## Practice location
- **Address:** 1930 MESQUITE AVE, SUITE # 1A, Lake Havasu City, AZ 86403
- **Phone:** (928) 855-4900 · **Fax:** (928) 855-4902
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Azpen Counseling & Services, LLC (NPI 1134668841, Lake Havasu City, AZ), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2013
## Record status
- **NPPES last updated:** August 30, 2019
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Source: [NPI Profile](https://npiprofile.com/npi/1124431101) · Data from the CMS NPPES public registry.