Individual provider Active NPI

Shaniqua Lashae Moore, LCSW

  • Clinical Social Worker
  • North Chesterfield, VA
National Provider Identifier
1215784277
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904016743 Issued in VA
Practice address
9321 Midlothian Tpke Ste C
North Chesterfield, VA 23235-4941
Phone
(804) 252-4525
NPI assigned
May 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2024

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 0904016743 VA Primary

Addresses

Primary practice location

9321 Midlothian Tpke Ste C
North Chesterfield, VA 23235-4941

Mailing address

9321 Midlothian Tpke Ste C
North Chesterfield, VA 23235-4941
Phone (804) 252-4525

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
0904016743VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Circle of Wellness LLC Clinical CurrentSince Aug 13, 2024 Accepting new patients

Locations

9321 Midlothian Tpke
Ste C
North Chesterfield, VA 23235
Phone (804) 252-4525

Organizations & group practices 1

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": "1714953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1215784277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9321 MIDLOTHIAN TPKE STE C",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232354941",
            "telephone_number": "804-252-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9321 MIDLOTHIAN TPKE STE C",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232354941",
            "telephone_number": "804-252-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SHANIQUA",
        "middle_name": "LASHAE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904016743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chesterfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.