Individual provider Active NPI

Kaitlin Moran

  • Clinical Social Worker
  • Brick, NJ
National Provider Identifier
1063183564
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC06026500 Issued in NJ
Practice address
445 Brick Blvd Ste 204
Brick, NJ 08723-6079
Phone
(732) 908-7966
NPI assigned
Sep 23, 2021
Last updated
Sep 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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 44SC06026500 NJ Primary

Addresses

Primary practice location

445 Brick Blvd Ste 204
Brick, NJ 08723-6079

Mailing address

133 Lincoln Ave
Avon by the Sea, NJ 07717-1310
Phone (732) 996-1192

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Brick Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20220920000146 NJ Practitioner - Clinical Social Worker 0648655100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

133 Lincoln Ave
Avon by the Sea, NJ 07717-1310
Phone (732) 908-7966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Direct Solutions Counseling LLC Clinical CurrentSince Jun 9, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1063183564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 LINCOLN AVE",
            "city": "AVON BY THE SEA",
            "state": "NJ",
            "postal_code": "077171310",
            "telephone_number": "732-996-1192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 BRICK BLVD STE 204",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087236079",
            "telephone_number": "732-908-7966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "KAITLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-23",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06026500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Brick",
            "affiliation": "N",
            "endpointDescription": "Office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Brick",
            "address_1": "445 Brick Blvd Ste 204",
            "city": "Brick",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "087236079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.