Aaron Tyler Moore
Individual provider Active NPI Social Worker · Dousman, WI
NPI 1023927522 · NPPES record last updated Sep 2, 2026
Key facts
- NPI
- 1023927522
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 135995-121 (WI)
- Practice address
- S24W36044 Countryside CT
Dousman, WI 53118-9688 - Phone
- (608) 886-0240
- NPI assigned
- Sep 2, 2026
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 135995-121 | WI | Yes |
Addresses
Primary practice location
S24W36044 Countryside CT
Dousman, WI 53118-9688
Mailing address
S24W36044 Countryside CT
Dousman, WI 53118-9688
Phone (608) 886-0240
Other providers in Dousman, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.