Individual provider Active NPI

Kristen Moreno, LLMSW

  • Clinical Social Worker
  • Mount Clemens, MI
National Provider Identifier
1205370541
Registry record updated Dec 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801098388 Issued in MI
Practice address
2 Crocker Blvd
Suite 101
Mount Clemens, MI 48043-2528
Phone
(586) 468-2266
NPI assigned
Dec 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801098388 MI Primary

Addresses

Primary practice location

2 Crocker Blvd
Suite 101
Mount Clemens, MI 48043-2528

Mailing address

2 Crocker Blvd
Suite 101
Mount Clemens, MI 48043-2528
Phone (586) 468-2266

Other names 1

  • Kristen Lobstein Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801098388MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Youth Services Inc PastSince Jun 10, 2005 Accepting new patients
Answers Within Counseling, PLLC Past Accepting new patients
Essential Wellness Center, LLC Clinical PastSince Oct 31, 2021 Accepting new patients

Organizations & group practices 3

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": "1480982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480982400000",
    "number": "1205370541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CROCKER BLVD",
            "address_2": "SUITE 101",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432528",
            "telephone_number": "586-468-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CROCKER BLVD",
            "address_2": "SUITE 101",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432528",
            "telephone_number": "586-468-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "KRISTEN",
        "name_prefix": "Mrs.",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-06",
        "last_updated": "2016-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801098388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "LOBSTEIN",
            "credential": "LLMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mount Clemens, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.