SOUA LY MOUA – Marriage & Family Therapist, NPI 1053442707

SOUA LY MOUA is a healthcare provider. based in Gresham, Oregon. specializing in Marriage & Family Therapist. They hold a License No. MFC50724 (CA). The NPI Number for SOUA LY MOUA is 1053442707

Main info

Female
Name
SOUA LY MOUA
NPI
1053442707
Phone
(562) 644-4413
Address
330 NE GREENWAY DR
Enumeration Date
7 March 2007
Last Update Date
17 December 2020
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

Provider Addresses for SOUA LY MOUA

  • 330 NE GREENWAY DR

    GRESHAM, OR 970301702

    Phone: (562) 644-4413

    Type: Mailing

  • 12440 FIRESTONE BLVD

    NORWALK, CA 906504328

    Phone: (562) 864-3722

    Type: Mailing

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: 2025-01-08

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
I20250108002816IMarriage And Family TherapistCATBD

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

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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 97030)

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Reviews

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Frequently asked questions

Is SOUA LY MOUA listed with a National Provider Identifier?
Yes — SOUA LY MOUA has NPI 1053442707 on file in the registry.
Is there an active status for SOUA LY MOUA?
For scheduling context, SOUA LY MOUA is shown as active in the registry.
What area of care is associated with SOUA LY MOUA?
SOUA LY MOUA's record emphasizes Marriage & Family Therapist. Clinical services aligned with this taxonomy classification.
What locale is associated with SOUA LY MOUA?
Directory geography for SOUA LY MOUA centers on Gresham, Oregon.
When was this NPI issued?
Enumeration for SOUA LY MOUA is noted as March 7, 2007 where the registry provides it.

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