LATREASE R MOORE LMHC
NPI 1497114920
Psychologist - Clinical in Utica, NY
About Latrease R Moore Lmhc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LATREASE R MOORE LMHC (NPI 1497114920) is an individual clinical provider in Utica, New York, licensed in New York (024435-01) and active in the NPI registry since February 2016. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Latrease R Moore Lmhc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Latrease Moore reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Utica, NY 13502
- Reassigned Medicare billing, New York enrollment
- 10 clinicians in this Medicare group
Rome, NY 13440
- Reassigned Medicare billing, New York enrollment
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 13502 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 12
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
UTICA, NY 13502
UTICA, NY 13502
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 Latrease Moore's NPI number?
The NPI number for Latrease Moore is 1497114920. It was assigned to this individual provider in the NPPES registry on February 11, 2016.
Where is Latrease Moore located?
Latrease Moore practices at 1612 Genesee St, Utica, NY 13502. The listed phone number is (315) 724-5173.
What is Latrease Moore's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Latrease Moore enrolled in Medicare?
Yes. Latrease Moore is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Latrease Moore's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Latrease Moore reassigns Medicare benefits to 2 organizations: Samaritan Counseling Center Of The Mohawk Valley, Inc (Utica, NY) and K & M Wellness, Inc (Rome, NY). Each 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 Latrease Moore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Latrease Moore was last updated on December 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Latrease R Moore, LMHC · NPI 1497114920
Clinical provider in Utica, New York. Individual provider, active in the CMS NPPES registry since February 11, 2016.
## Identity
- **NPI:** 1497114920 (Entity type: Individual)
- **Enumerated:** February 11, 2016
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **State license:** 024435-01 (New York)
- **Sole proprietor:** No
## Practice location
- **Address:** 1612 GENESEE ST, Utica, NY 13502-5425
- **Phone:** (315) 724-5173
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Samaritan Counseling Center Of The Mohawk Valley, Inc (NPI 1649377854, Utica, NY); K & M Wellness, Inc (NPI 1013696012, Rome, NY) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 1, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1497114920) · Data from the CMS NPPES public registry.