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Casey Moody

Social Worker

Behavioral Health & Social Service Providers

6440 S Lewis Ave Ste 2200, Tulsa, OK 74136-1060

PECOS Enrollment

This provider is enrolled in PECOS as CASEY HOLT.

Based on the most recent information from CMS, provider Casey Moody is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 11:47 AM.

Profile Details

Provider ID
1841636362
Provider Type
Individual
Full Name
Moody, Casey
Credential
LCSW

Gender
Female
Sole Proprietor
No
Enumeration Date
5/13/2013
Last Updated
3/5/2024

Contact Information

Practice Location

6440 S Lewis Ave Ste 2200, Tulsa, OK 74136-1060

(918) 712-0859

(918) 388-6456

Mailing Location

1601 Old South River Rd, Saint Charles, MO 63303-4120

(636) 224-1210

(636) 246-1008

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 7060 Oklahoma
Code 1041C0700X	Description Social Worker Behavioral Health & Social Service Providers	License 2021011487 Missouri

Provider Identifiers

ID	Description	Issuer
ID 200486370B	Description Medicaid	Issuer Unlisted Oklahoma
ID 100746170G	Description Medicaid	Issuer Unlisted Oklahoma
ID 490082172	Description Medicaid	Issuer Unlisted Missouri

Casey Moody

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Foreman, Amy

Greenfield, Wilma Louise

Pyle, Kathryn Lee

Keeter, Kimberly D

Raulston, Matthew Wayne

Brizendine, April Lynn

Baughman, James R

Kettlewood, Anna Maria

Jennifer Cremin Sellers, Pllc

Reverence Counseling & Consulting