Individual provider Active NPI

John Thomas Livick-Moses, LICSW

  • Clinical Social Worker
  • Quincy, MA
National Provider Identifier
1184241671
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
126552 Issued in MA
Practice address
1261 Furnace Brook Pkwy Ste 31
Quincy, MA 02169-4768
Phone
(617) 479-4545
NPI assigned
Jun 30, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 126552 MA Primary
Clinical Social Worker 1041C0700X 000225892 MA

Addresses

Primary practice location

1261 Furnace Brook Pkwy Ste 31
Quincy, MA 02169-4768

Mailing address

2274 Pinnacle CT
Erie, PA 16506-6439
Phone (540) 290-7176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20210212002234 MA Practitioner - Clinical Social Worker 1052726619

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

851 Main St
Suite 4
Weymouth, MA 02190-0009

851 Main St
Suite 4
Weymouth, MA 02190-1613

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000225892MAMDClinical Social Worker
126552MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Psychiatric Service PastSince Jul 5, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1184241671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2274 PINNACLE CT",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165066439",
            "telephone_number": "540-290-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 FURNACE BROOK PKWY STE 31",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694768",
            "telephone_number": "617-479-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVICK-MOSES",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-30",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "126552",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "000225892",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.