Thomas Wayne Moll, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.010950 Issued in IL

Practice address

PO Box 144
Herrick, IL 62431-0144

Phone

(217) 343-9079

NPI assigned

Feb 4, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: thomasmoll@siusm.allscriptsdirect.net

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.

• Board of Trustees of Southern Illinois University

  • Primary Care Clinic/Center
  • Springfield, IL
  • NPI 1396097960
  Medicare reassignment NPD
• Board of Trustees of Southern Illinois University

  • Rural Health Clinic/Center
  • Carbondale, IL
  • NPI 1215978127
  NPD
• Board of Trustees of Southern Illinois University

  • Federally Qualified Health Center (FQHC)
  • Carbondale, IL
  • NPI 1568210425
  NPD
• Board of Trustees of Southern Illinois University

  • Primary Care Clinic/Center
  • Springfield, IL
  • NPI 1922350099
  NPD
• Christian County Mental Health Association

  • Community/Behavioral Health Agency
  • Taylorville, IL
  • NPI 1831267210
  NPD (past)
• County of Christian

  • Public Health or Welfare Agency
  • Taylorville, IL
  • NPI 1538380837
  NPD (past)
• John Herington, PC

  • Clinical Social Worker
  • Decatur, IL
  • NPI 1598869588
  NPD (past)

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

{
    "created_epoch": "1170547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1053459503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 144",
            "city": "HERRICK",
            "state": "IL",
            "postal_code": "624310144",
            "telephone_number": "217-343-9079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 144",
            "city": "HERRICK",
            "state": "IL",
            "postal_code": "624310144",
            "telephone_number": "217-343-9079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLL",
        "first_name": "THOMAS",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-04",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.010950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thomas.moll@famcare.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "thomas.moll@famcare.eclinicaldirectplus.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1106 N Merchant St",
            "city": "Effingham",
            "state": "IL",
            "country_code": "US",
            "postal_code": "624012128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emily Elizabeth Ade
• Mollie Cutler
• Heather Logue, PHDH
• Donna Marie McKittrick, RT(R)(MR)
• Holly E Richards
• Brandi Voudrie

• Clinical Social Worker in Herrick, IL
• Providers in Herrick, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.