Misty Dawn Moniz, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LMSW-41670 Issued in ID

Practice address

110 E Walnut St
Pocatello, ID 83201-4570

Phone

(208) 549-7246

NPI assigned

Oct 10, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ID

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

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.

• Pearl Health Clinic

  • Mental Health Counselor
  • Ammon, ID
  • NPI 1447426465
  Medicare reassignment NPD

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1194440453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10857 N NADA LN",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832025339",
            "telephone_number": "120-860-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E WALNUT ST",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014570",
            "telephone_number": "208-549-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONIZ",
        "first_name": "MISTY",
        "middle_name": "DAWN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-41670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mistym@americahealth.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "110 E Walnut St",
            "city": "Pocatello",
            "state": "ID",
            "country_code": "US",
            "postal_code": "832014570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Micah Moeai, M.S., ATC
• Kelly Mitten Moellmer
• Diane K. Moll
• Mary Paul Moller, LMFT
• Danielle Molsee, LMSW
• Gabe Monroe, PA-C
• Monte Page Family Dentistry
• Clarice Montecalvo, M.D.
• Jason Montgomery, NP-C
• Hannah Montrose

• Social Worker in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Social Worker in Idaho

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