Kathleen Mary Moore, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I-05567 Issued in NM

Practice address

1218 Griegos Rd NW
Albuquerque, NM 87107-3752

Phone

(505) 342-5450

NPI assigned

Aug 8, 2011

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312761600000",
    "number": "1245519396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 ARNO ST SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023514",
            "telephone_number": "505-710-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 GRIEGOS RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871073752",
            "telephone_number": "505-342-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KATHLEEN",
        "middle_name": "MARY",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-08",
        "last_updated": "2011-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-05567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jiaymeta Moore
• John-Robert Calvin Moore, D.C.
• Karla Rae Moore, LMHC, LSAA
• Katharine Jeanne Moore, FNP-BC
• Kathleen Moore
• Kellie Moore
• Kimberly Moore
• Laroy J Moore, PSYS
• Lauren Moore, LMT, NTS, NASM-CPT
• Lauren Moore

• Clinical Social Worker in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2011; 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.