Miguel Angel Moreno Lopez, MSW, LCSW, NCICS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

121978 Issued in CA

Practice address

31946 Mission TRL Ste B
Lake Elsinore, CA 92530

Phone

(951) 471-4300

Fax

(951) 674-6431

NPI assigned

Feb 22, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1456099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1124487988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31946 MISSION TRL STE B",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304539",
            "telephone_number": "951-471-4300",
            "fax_number": "951-674-6431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31946 MISSION TRL STE B",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "92530",
            "telephone_number": "951-471-4300",
            "fax_number": "951-674-6431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO LOPEZ",
        "first_name": "MIGUEL",
        "middle_name": "ANGEL",
        "credential": "MSW, LCSW, NCICS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-22",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "95128",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "121978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Alicia Montero, ASW
• Richard Moody
• Christina M Moore-Peters, M.ED
• Joseph Moore
• Jaime Mora
• Juan Moreno
• Marissa Moreno
• Cristina Lymn Morris
• Frank Perry Mosca
• Julie Deann Moser, LAADC-CA

• Clinical Social Worker in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.

Verify at the official NPI Registry.