Lucila A. Moreno, LISW-S
Individual provider Active NPI Clinical Social Worker · Bryan, OH
NPI 1194949396 · NPPES record last updated Mar 19, 2026
Key facts
- NPI
- 1194949396
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- I 0007980 (OH)
- Practice address
- 5030 County Road 15 Ste C
Bryan, OH 43506-9767 - Phone
- (419) 636-1713
- Fax
- (419) 445-1401
- NPI assigned
- Apr 12, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151211001683 | OH | Practitioner - Clinical Social Worker | 5991006181 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I 0007980 | OH | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shalom Ministries | Current |
Accepting new patients | |
| Defiance Hospital, Inc. | Current | Accepting new patients |
Locations
22251 State Route 2
Archbold, OH 43502
Phone (419) 445-1552
5030 County Road 15
#C
Bryan, OH 43506
Phone (419) 636-1713
1200 Ralston Ave
Defiance, OH 43512
Phone (419) 783-6944
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I 0007980 | OH | Yes |
Addresses
Primary practice location
5030 County Road 15 Ste C
Bryan, OH 43506-9767
Mailing address
22251 State Route 2
Archbold, OH 43502-9452
Phone (419) 445-1552
Other practice location 1
22251 State Route 2
Archbold, OH 43502-9452
Phone (419) 445-1552
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0174661 | Medicaid | OH |
Other names
- Lucila A. Peralez-Moreno
Other providers in Bryan, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.