Individual provider Active NPI

Christiana Moore, MPA, MSW, LCSW

  • Clinical Social Worker
  • Phoenix, AZ
National Provider Identifier
1013260405
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-13622 Issued in AZ
Practice address
3807 N 7TH St
Valle del Sol
Phoenix, AZ 85014-5005
Phone
(480) 331-4539
NPI assigned
Oct 22, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-13622 AZ Primary

Addresses

Primary practice location

3807 N 7TH St
Valle del Sol
Phoenix, AZ 85014-5005

Mailing address

3807 N 7TH St
Valle del Sol
Phoenix, AZ 85014-5005
Phone (480) 331-4539

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-13622AZMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1013260405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3807 N 7TH ST",
            "address_2": "VALLE DEL SOL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850145005",
            "telephone_number": "480-331-4539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3807 N 7TH ST",
            "address_2": "VALLE DEL SOL",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850145005",
            "telephone_number": "480-331-4539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHRISTIANA",
        "name_prefix": "Ms.",
        "credential": "MPA, MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-22",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-13622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.