Individual provider Active NPI

Consuelo Moreno, LCSW

  • Clinical Social Worker
  • North Miami, FL
National Provider Identifier
1043659782
Registry record updated Jun 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW11443 Issued in FL
Practice address
640 NE 124TH St
North Miami, FL 33161-5523
Phone
(305) 891-4114
NPI assigned
Jun 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2013

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 SW11443 FL Primary

Addresses

Primary practice location

640 NE 124TH St
North Miami, FL 33161-5523

Mailing address

640 NE 124TH St
North Miami, FL 33161-5523
Phone (305) 891-4114

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
SW11443FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1371340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371340800000",
    "number": "1043659782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 NE 124TH ST",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331615523",
            "telephone_number": "305-891-4114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 NE 124TH ST",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331615523",
            "telephone_number": "305-891-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "CONSUELO",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-16",
        "last_updated": "2013-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2013; 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.