Stephanie Moore, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

988 N Illinois Route 3
Waterloo, IL 62298-1059

Phone

(618) 939-4444

NPI assigned

Aug 16, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christian Social Services of IllinoisGroup PAC ID 3870068125, 3 clinicians

Human Support ServicesGroup PAC ID 8729166434, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Human Support Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waterloo, IL
  • NPI 1851314918

  IL

  Medicare reassignment Care Compare group NPD
• Christian Social Services of Illinois

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Belleville, IL
  • NPI 1154399780

  IL

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1013682525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988 N ILLINOIS ROUTE 3",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981059",
            "telephone_number": "618-939-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988 N ILLINOIS ROUTE 3",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622981059",
            "telephone_number": "618-939-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "STEPHANIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monroe County
• Monroe County
• Monroe County Surgical Center,LLC
• Allyson Mooney, RSA
• Bobbi Moore, MHP
• Tina Marie Moore
• Erynne Morgan, QMHP
• Laura Morton, RD, LDN
• Patricia Mary Jean Mosbacher, L.C.S.W.
• Msa Alliance, LLC

• All providers in Waterloo, IL
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.