Individual provider Active NPI

Joanne Moore, LCSW-R

  • Clinical Social Worker
  • Jamestown, NY
National Provider Identifier
1053629071
Registry record updated Sep 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R072867 Issued in NY
Practice address
610 W 3Rd St
Jamestown, NY 14701-4705
Phone
(877) 730-9111
Fax
(716) 483-0050
NPI assigned
Sep 24, 2010
Last updated
Sep 24, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2010

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 R072867 NY Primary

Addresses

Primary practice location

610 W 3Rd St
Jamestown, NY 14701-4705

Mailing address

610 W 3Rd St
Jamestown, NY 14701-4705
Phone (877) 730-9111

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
R072867NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1285286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285286400000",
    "number": "1053629071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 W 3RD ST",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147014705",
            "telephone_number": "877-730-9111",
            "fax_number": "716-483-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 W 3RD ST",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147014705",
            "telephone_number": "877-730-9111",
            "fax_number": "716-483-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JOANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-24",
        "last_updated": "2010-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R072867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2010; 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.