AUDREA MAURINE MOORE (LMHC) – Mental Health Counselor, NPI 1124161153

AUDREA MAURINE MOORE (LMHC) is a healthcare provider. based in Lutz, Florida. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LMHC. They hold a License No. MH8581 (FL). The NPI Number for AUDREA MAURINE MOORE (LMHC) is 1124161153

Main info

Female
31 Years Of Experience
Accepts Medicare Assignment
Name
AUDREA MAURINE MOORE (LMHC)
NPI
1124161153
Phone
(813) 714-9792
Address
1506 CANNONADE CT
Enumeration Date
15 February 2007
Last Update Date
19 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4074212031
Graduation Year
1995 (31 years ago)
PAC ID
8325496144
Group Practice PAC ID
6507200235
Professional Enrollment ID
I20231204002907
Address ID
FL34748XXXXLEXXXXXXXXXX00
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness75
Years active:19State licenses:1Digital endpointsOther names

3,018 MENTAL HEALTH COUNSELOR in FL

Provider Addresses for AUDREA MAURINE MOORE (LMHC)

  • 1506 CANNONADE CT

    LUTZ, FL 335495822

    Phone: (813) 714-9792

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-12-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231204002907IMental Health CounselorFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33549)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6507200235View full group profile
NameSpecialtyState
Mental Health CounselorFL

Reviews

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Frequently asked questions

What unique ID ties claims to AUDREA MAURINE MOORE (LMHC)?
NPI 1124161153 is assigned to AUDREA MAURINE MOORE (LMHC) under the national enumeration system.
Is AUDREA MAURINE MOORE (LMHC)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does AUDREA MAURINE MOORE (LMHC) treat or focus on?
Patients typically see AUDREA MAURINE MOORE (LMHC) under the specialty Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What location metadata exists for AUDREA MAURINE MOORE (LMHC)?
The page summarizes Lutz, Florida for AUDREA MAURINE MOORE (LMHC); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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