Active NPI
Reynier Urdaneta Moreno Sr.
- Clinical Social Worker
- Holt, MI
National Provider Identifier
1063321099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6851122547
- Practice address
- 5885 Holt Rd
Holt, MI 48842-8677 - Phone
- (517) 694-2162
- NPI assigned
- Sep 4, 2026
- Sex
- Male
- Sole proprietor
- Yes
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 | 6851122547 | MI | Primary |
Addresses
Primary practice location
5885 Holt Rd
Holt, MI 48842-8677
Mailing address
407 W Greenlawn Ave
Lansing, MI 48910-2819
Phone (517) 882-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788480000000",
"number": "1063321099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "407 W GREENLAWN AVE",
"city": "LANSING",
"state": "MI",
"postal_code": "489102819",
"telephone_number": "517-882-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5885 HOLT RD",
"city": "HOLT",
"state": "MI",
"postal_code": "488428677",
"telephone_number": "517-694-2162"
}
],
"practiceLocations": [],
"basic": {
"last_name": "URDANETA MORENO",
"first_name": "REYNIER",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-09-04",
"last_updated": "2026-09-04",
"certification_date": "2026-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6851122547",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holt, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.