Jennifer Moon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7793-C Issued in AR

Practice address

2230 Harrison St
Batesville, AR 72501-7417

Phone

(870) 698-2100

Fax

(870) 698-0109

NPI assigned

Sep 30, 2011

Last updated

Jan 11, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1317340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452470400000",
    "number": "1215211826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 HARRISON ST",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017417",
            "telephone_number": "870-698-2100",
            "fax_number": "870-698-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 HARRISON ST",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725017417",
            "telephone_number": "870-698-2100",
            "fax_number": "870-698-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-30",
        "last_updated": "2016-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "7793-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MKJD, LLC (STARS Academy South)
• MKJD, LLC (STARS Academy)
• Ashley Montgomery
• Lackey Gene Moody, M.D.
• Melody Lynne Moody, MD
• Anna Moore, NP
• Brandy M Moore, APRN
• Jefferson Wilburn Moore Jr., APN
• Myra Colleen Moore, DNP, APRN, FNP-C
• Shelby Moore

• Clinical Social Worker in Batesville, AR
• Providers in Batesville, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.