Kerianne Mauch Moon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

60361 Issued in TX

Practice address

10011 Little Creek Cir
Dripping Springs, TX 78620-2645

Phone

(218) 831-0075

NPI assigned

Dec 8, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1194884841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10011 LITTLE CREEK CIR",
            "city": "DRIPPING SPRINGS",
            "state": "TX",
            "postal_code": "786202645",
            "telephone_number": "218-831-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10011 LITTLE CREEK CIR",
            "city": "DRIPPING SPRINGS",
            "state": "TX",
            "postal_code": "786202645",
            "telephone_number": "218-831-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "KERIANNE",
        "middle_name": "MAUCH",
        "name_prefix": "Dr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16592",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "60361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113415900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dustin Graham Moore, M.D.
• Frosty Doyle Randall Moore, M.D.
• Grayson Armstrong Moore, M.D.
• Amanda Mossaro, MS, CCC-SLP
• Seyedbaubak Mostafavinaeini, PHARMD

• Clinical Social Worker in Dripping Springs, TX
• Providers in Dripping Springs, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.