JODELL LYNN MOON (M.ED., LPC, LMHC) – Mental Health Counselor, NPI 1477520716

JODELL LYNN MOON (M.ED., LPC, LMHC) is a healthcare provider. based in Oklahoma city, Oklahoma. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials M.ED., LPC, LMHC. They hold a License No. LH61095791 (WA). The NPI Number for JODELL LYNN MOON (M.ED., LPC, LMHC) is 1477520716

Main info

Female
Sole Proprietor
27 Years Of Experience
Accepts Medicare Assignment
Name
JODELL LYNN MOON (M.ED., LPC, LMHC)
NPI
1477520716
Phone
(405) 417-4541
Address
14201 N KENTUCKY AVE
Enumeration Date
7 March 2006
Last Update Date
9 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3092304000
Graduation Year
1999 (27 years ago)
PAC ID
6901257914
Group Practice PAC ID
5799136701
Professional Enrollment ID
I20240103004000
Address ID
WY825208816AT59XXXAVEX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience78
Completeness85
Years active:20State licenses:2Digital endpointsOther names

1,199 MENTAL HEALTH COUNSELOR in OK

Provider Addresses for JODELL LYNN MOON (M.ED., LPC, LMHC)

  • 14201 N KENTUCKY AVE

    OKLAHOMA CITY, OK 731343427

    Phone: (405) 417-4541

    Type: Mailing

  • RED ROCK BHS

    112 MCKINLEY STREET

    CHANDLER, OK 74834

    Phone: (405) 240-5800

    Fax: (405) 240-5008

    Type: Mailing

  • 112 MCKINLEY STREET

    CHANDLER, OK 74834

    Phone: (405) 240-5800

    Fax: (405) 240-5008

    Type: Location

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: 2026-02-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20240103004000IMental Health CounselorWYTBD
I20260217004259IMental Health CounselorOKTBD

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 73134)

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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: 5799136701View full group profile
NameSpecialtyState
Clinical Social WorkerPA
Clinical Social WorkerCT
Clinical Social WorkerSC
Mental Health CounselorMS
Mental Health CounselorMS
Mental Health CounselorWA
Mental Health CounselorOR
Clinical Social WorkerKY
Clinical Social WorkerHI
Clinical Social WorkerPA

Reviews

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Frequently asked questions

What is the 10-digit NPI for JODELL LYNN MOON (M.ED., LPC, LMHC)?
JODELL LYNN MOON (M.ED., LPC, LMHC) — NPI 1477520716 — is the standard way to identify this listing.
Is JODELL LYNN MOON (M.ED., LPC, LMHC) listed as active for patients and plans?
The listing shows JODELL LYNN MOON (M.ED., LPC, LMHC) as active in the NPI system.
What is JODELL LYNN MOON (M.ED., LPC, LMHC)'s primary classification?
Mental Health Counselor is the headline specialty for JODELL LYNN MOON (M.ED., LPC, LMHC) here. Clinical services aligned with this taxonomy classification.
What area does JODELL LYNN MOON (M.ED., LPC, LMHC) serve?
JODELL LYNN MOON (M.ED., LPC, LMHC)'s listing highlights Oklahoma City, Oklahoma; more addresses can appear in NPPES.
Is the information about JODELL LYNN MOON (M.ED., LPC, LMHC) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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