Tracey Moore, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2020037895 Issued in MO

Practice address

4625 Lindell Blvd
Ste 200&300
Saint Louis, MO 63108-3725

Phone

(636) 374-9113

NPI assigned

Apr 2, 2022

Last updated

Apr 2, 2022By the provider in NPPES

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1648857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648857600000",
    "number": "1144961467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4625 LINDELL BLVD STE 200&300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631083725",
            "telephone_number": "636-674-9113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 LINDELL BLVD",
            "address_2": "STE 200&300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631083725",
            "telephone_number": "636-374-9113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TRACEY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-02",
        "last_updated": "2022-04-02",
        "certification_date": "2022-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2020037895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Moore
• Terrie Denise Moore
• Terry Lynn Moore, M.D.
• Tessa Moore
• Tia A'Jonea Moore
• Tracy L. Moore, CPNP
• Eresarena Marina Moorehead
• Ava Moorhead, DO
• Ashley Mooring, MSW
• Kristin Gail Moormann Williams

• Clinical Social Worker in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2022; 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.