NPIMap

Organization Active NPI

Jennifer C Moore MSW LCSW Inc

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1225280969
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2948C Issued in NV
Legal business name
JENNIFER C MOORE MSW LCSW INC
Practice address
7180 Cascade Valley CT Ste 200
Las Vegas, NV 89128-0481
Phone
(702) 240-8639
Fax
(702) 240-6970
NPI assigned
Oct 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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

Authorized official

Name
Mrs. Jennifer Claire Moore, LCSWNPI 1407977523
Title
President
Phone
(702) 240-8639

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 2948C NV Primary

Addresses

Primary practice location

7180 Cascade Valley CT Ste 200
Las Vegas, NV 89128-0481

Mailing address

PO Box 370763
Las Vegas, NV 89137-0763
Phone (702) 691-1920

Other practice location 1

660 S Green Valley Pkwy Ste 150
Henderson, NV 89052-0432
Phone (702) 240-8639 ext. 1

Other identifiers 1

IdentifierTypeStateIssuer
100511332MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081110000785 NV Part B Supplier - Clinic/Group Practice 8628137304 Receives reassigned benefits from 11 practitioners
Practice locations: Henderson, NV; Las Vegas, NV
O20250929004017 TX Part B Supplier - Clinic/Group Practice 8628137304 Receives reassigned benefits from 2 practitioners
Practice locations: Pflugerville, TX

National Provider Directory

National Provider Directory
Tax ID family
Jennifer C Moore MSW LCSW Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

660 S Green Valley Pkwy
Ste 150
Henderson, NV 89052
Phone 7022408639 ext. 1

2921 N Tenaya Way
Ste 235
Las Vegas, NV 89128
Phone (702) 556-7291

7180 Cascade Valley Ct
Ste 200
Las Vegas, NV 89128
Phone (702) 240-8639

305 N Heatherwilde Blvd
Ste 150
Pflugerville, TX 78660
Phone (800) 992-9485

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1223942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609113600000",
    "number": "1225280969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370763",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891370763",
            "telephone_number": "702-691-1920",
            "fax_number": "702-240-6970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7180 CASCADE VALLEY CT STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280481",
            "telephone_number": "702-240-8639",
            "fax_number": "702-240-6970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "660 S Green Valley Pkwy Ste 150",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890520432",
            "country_code": "US",
            "telephone_number": "702-240-8639 x1",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JENNIFER C MOORE MSW LCSW INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-14",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "CLAIRE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-240-8639",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "2948C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100511332",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.