Ann Marie Moylan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15431 Issued in OR

Practice address

1717 NE 42ND Ave Ste 3100
Portland, OR 97213-1572

Phone

(503) 567-5103

NPI assigned

Jun 9, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Larsen Sanchez Psychology, LLC

  • Clinical Psychologist
  • Portland, OR
  • NPI 1588041388
  Medicare reassignment NPD
• Lutheran Family Services of NE, Inc

  • Mental Health Counselor
  • Omaha, NE
  • NPI 1639121726
  NPD (past)

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1164099081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 NE 42ND AVE STE 3100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131572",
            "telephone_number": "503-567-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 NE 42ND AVE STE 3100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131572",
            "telephone_number": "503-567-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYLAN",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-09",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "6126",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "15431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Moyer, PHD
• Kathryn D Moyer, M.D.
• Kendall Moyer
• Megan Moyer
• Brian Scott Moyers, MD
• Steven Gabriel Moylan, DO
• Rachel Moyles, OTR/L
• Bethany Jean Lane Moyses, O.D.
• Roma Moza, MD
• John D Mozena, DPM

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.