Lora Shae Moultrie, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW14467 Issued in FL

Practice address

551 National Health Care Dr
Daytona Beach, FL 32114-1495

Phone

(386) 323-7500

NPI assigned

May 14, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1063902179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "471 JEANNETTE DR",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321746107",
            "telephone_number": "386-254-9997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 NATIONAL HEALTH CARE DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141495",
            "telephone_number": "386-323-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULTRIE",
        "first_name": "LORA",
        "middle_name": "SHAE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-14",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haley Moscoso
• Cheryl Marie Moses, M.D.
• Nancy Johnson Moses, SPEECH LANGUAGE PATH
• Motion for Life LLC
• Nolan K Mott, D.O.
• Catherine Elaine Moutsopoulos, D.C.
• Alexandra M Moyer
• MRB Acquisition Corp (Lincare Powered Mobility)
• Sara Rosann Mucaria
• Paul Mucciolo, MD

• Clinical Social Worker in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; 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.