Active NPI
Amanda Marie Moreno, LCSW
- Clinical Social Worker
- Austin, TX
National Provider Identifier
1104203637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 54527
- Practice address
- 3804 Avenue B
Austin, TX 78751-4906 - Phone
- (512) 459-3353
- NPI assigned
- May 5, 2015
- Last updated
- May 5, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 54527 | TX | Primary |
Addresses
Primary practice location
3804 Avenue B
Austin, TX 78751-4906
Mailing address
3804 Avenue B
Austin, TX 78751-4906
Phone (512) 459-3353
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bluebonnet Trails Community MHMR Center | Current | Accepting new patients | |
| Bluebonnet Trails Community MHMR Center | Clinical | Current | Accepting new patients |
| Helping Hand Home for Children | Past | Accepting new patients |
Locations
1009 N Georgetown St
Round Rock, TX 78664
Phone (512) 244-8374
Organizations & group practices 3
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.
-
dba Bluebonnet Trails Community Services
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Round Rock, TX
- NPI 1730135864
Clinical
-
dba Bluebonnet Trails Community Services
- Rural Health Clinic/Center
- La Grange, TX
- NPI 1518536309
-
- Emotionally Disturbed Childrens' Residential Treatment Facility
- Austin, TX
- NPI 1902029200
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430784000000",
"number": "1104203637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3804 AVENUE B",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787514906",
"telephone_number": "512-459-3353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3804 AVENUE B",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787514906",
"telephone_number": "512-459-3353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORENO",
"first_name": "AMANDA",
"middle_name": "MARIE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-05",
"last_updated": "2015-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "54527",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; 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.