MS. ODETTA MARIA MOORE LPC
NPI 1689958894
Counselor - Professional in Tulsa, OK

Q: What is Odetta Moore's NPI number?

The NPI number for Odetta Moore is 1689958894. It was assigned to this individual provider in the NPPES registry on October 6, 2011.

Q: What is Odetta Moore's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Odetta Moore was last updated on April 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.

Active since October 06, 2011PECOS EnrolledAccepts Medicare Assignment

5310 E 31ST ST, TULSA, OK 74135(918) 600-3100(918) 560-1399 Get Directions Write a Review

NPPES record last updated: April 30, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Ms. Odetta Maria Moore Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. ODETTA MARIA MOORE LPC (NPI 1689958894) is an individual professional provider in Tulsa, Oklahoma, licensed in Oklahoma (LPC06275) and active in the NPI registry since October 2011. She is enrolled in Medicare PECOS, maintains a secondary practice location in Tulsa, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1689958894

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameMS. ODETTA MARIA MOORECredential: LPC

Location Address5310 E 31ST STTulsa, OK 74135-5018

Mailing AddressPo Box 701111Tulsa, OK 74170-1111 · (918) 406-7195

Phone(918) 600-3100

Fax(918) 560-1399

Sole ProprietorYes

Medical School CMSOtherGraduated 2010

Enumeration DateOctober 6, 2011

Last NPPES UpdateApril 30, 2025

NPPES CertifiedApril 30, 2025

✔ NPI 1689958894 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in OK · LPC06275

5310 E 31ST ST, Tulsa, OK 74135

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Secondary Practice Location 1

Location 16655 S Yale AveTulsa, OK 74136-3326 · Phone (918) 491-3700 · Fax (918) 481-4063

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma, CommunityCare, Medica.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Odetta Maria Moore 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.

PECOS PAC ID2860843521

PECOS Enrollment IDI20240105004122

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 30 minutes 90832

Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 30-minute session, the therapist helps you explore feelings, thoughts, and behaviors to better understand yourself and manage life's challenges.

151 services19 patients

Psychotherapy, 1 hour 90837

Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.

130 services11 patients

Psychiatric diagnostic evaluation 90791

A psychiatric diagnostic evaluation is a thorough assessment used to identify any mental health conditions you may have. It involves a detailed discussion about your symptoms, thoughts, feelings and behavior patterns. Your medical history and family's mental health history are also considered.

21 services20 patients

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. NICHOLAS CHARLES HENSON

Case Manager/Care Coordinator