Individual provider Active NPI

Sarah Nicole Moran, LCSW

  • Clinical Social Worker
  • West Haven, CT
National Provider Identifier
1033804141
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12914 Issued in CT
Practice address
415 Main St
West Haven, CT 06516-4296
Phone
(203) 931-1184
NPI assigned
Apr 6, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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 12914 CT Primary

Addresses

Primary practice location

415 Main St
West Haven, CT 06516-4296

Mailing address

76 Bluff Ave
West Haven, CT 06516-5703
Phone (203) 974-9609

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20230606003517 CT Practitioner - Clinical Social Worker 8820455801 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Fordham University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shoreline Wellness Behavioral Health Outreach IncGroup PAC ID 1951796119, 16 clinicians

Practice addresses (Care Compare)

415 Main St
West Haven, CT 06516-4296
Phone (203) 931-1184

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shoreline Wellness Behavioral Health Outreach Inc CurrentSince May 15, 2023 Accepting new patients
Mindhaus Wellness PLLC Clinical CurrentSince Apr 9, 2023 Accepting new patients
Shoreline Wellness Center, LLC. Clinical CurrentSince Apr 17, 2024 Accepting new patients

Locations

415 Main St
Lowr
West Haven, CT 06516

415 Main St
West Haven, CT 06516
Phone (203) 931-1184

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1680739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1033804141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 BLUFF AVE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065165703",
            "telephone_number": "203-974-9609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MAIN ST",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065164296",
            "telephone_number": "203-931-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "SARAH",
        "middle_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-06",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "12914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

Verify at the official NPI Registry.