Patricia Mary Jean Mosbacher, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149002118 Issued in IL

Practice address

220 Bradford LN Ste C
Waterloo, IL 62298-3370

Phone

(618) 939-3919

Fax

(618) 939-3920

NPI assigned

May 25, 2011

Last updated

May 11, 2023By 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 2

Addresses

Other names 1

• Patricia Mary Jean Kelley Former name

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rippling Waters Counseling PLLC

  dba Rippling Waters Counseling

  • Clinical Social Worker
  • Waterloo, IL
  • NPI 1427502855
  Medicare reassignment NPD Authorized official
• PCS Mso, LLC

  • Psychiatry Physician
  • Belleville, IL
  • NPI 1932057189
  NPD

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1164715918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 151",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622980151",
            "telephone_number": "618-830-8878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 BRADFORD LN STE C",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "622983370",
            "telephone_number": "618-939-3919",
            "fax_number": "618-939-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSBACHER",
        "first_name": "PATRICIA",
        "middle_name": "MARY JEAN",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-25",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2011003368",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149002118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "KELLEY",
            "middle_name": "MARY JEAN",
            "credential": "L.C.S.W.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bobbi Moore, MHP
• Stephanie Moore, LCSW
• Tina Marie Moore
• Erynne Morgan, QMHP
• Laura Morton, RD, LDN
• Msa Alliance, LLC
• Rebecca Mudd, ST
• Kodie Mueller Jones, RSA
• Brittany Mueth, DC
• Taylor Mulherin, QMHP

• Clinical Social Worker in Waterloo, IL
• Providers in Waterloo, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.