Active NPI
Kayla Moriarty, LCSW
- Clinical Social Worker
- Vicksburg, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C8626
- Practice address
- 1911 Mission 66 Ste B
Vicksburg, MS 39180-3762 - Phone
- (601) 665-4162
- Fax
- (855) 830-3484
- NPI assigned
- Sep 12, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C8626 | MS | Primary |
Addresses
Primary practice location
1911 Mission 66 Ste B
Vicksburg, MS 39180-3762
Mailing address
557 Grants Ferry Rd
Brandon, MS 39047-9023
Phone (601) 665-4162
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1727 E Union St
Greenville, MS 38703-3253
Phone (662) 537-4830
1911 Mission
66 Suite B
Vicksburg, MS 39180-3762
Phone (601) 456-2598
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C8626 | MS | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MDB Behavioral Health Services LLC | Current | Accepting new patients | |
| Uppal Medical Center LLC | Current | Accepting new patients | |
| Minor Med Care, LLC | Current | Accepting new patients |
Locations
557 Grants Ferry Rd
Brandon, MS 39047
Phone (601) 207-2017
1727 E Union St
Greenville, MS 38703
Phone (662) 332-0373
215 Katherine Dr
#A
Jackson, MS 39232
2860 McDowell Road Ext
Jackson, MS 39204
Phone (601) 372-1117
Networks
- LA PPO C-SNP
Organizations & group practices 4
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.
-
- Rural Health Clinic/Center
- Vicksburg, MS
- NPI 1669835310
-
- Rural Health Clinic/Center
- Greenville, MS
- NPI 1558927905
-
- Primary Care Clinic/Center
- Jackson, MS
- NPI 1407968738
-
- Rural Health Clinic/Center
- Raymond, MS
- NPI 1669575627
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662940800000",
"number": "1033830641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "557 GRANTS FERRY RD",
"city": "BRANDON",
"state": "MS",
"postal_code": "390479023",
"telephone_number": "601-665-4162",
"fax_number": "855-830-3484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1911 MISSION 66 STE B",
"city": "VICKSBURG",
"state": "MS",
"postal_code": "391803762",
"telephone_number": "601-665-4162",
"fax_number": "855-830-3484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORIARTY",
"first_name": "KAYLA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-12",
"last_updated": "2022-09-12",
"certification_date": "2022-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MS",
"license": "C8626",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vicksburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.