Natasha M. D. Moore, MSW, LCSW-A

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P011427 Issued in NC

Practice address

2543 Ravenhill Dr Ste B
Fayetteville, NC 28303-5459

Phone

(910) 339-1928

Fax

(910) 339-4650

NPI assigned

Apr 14, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Natasha Marie Davis Former name

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": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1255865440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2543 RAVENHILL DR STE B",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035459",
            "telephone_number": "910-339-1928",
            "fax_number": "910-339-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2543 RAVENHILL DR STE B",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035459",
            "telephone_number": "910-339-1928",
            "fax_number": "910-339-4650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 4th St",
            "address_purpose": "LOCATION",
            "city": "Parkersburg",
            "state": "WV",
            "postal_code": "261015313",
            "country_code": "US",
            "telephone_number": "304-916-1354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "NATASHA",
        "middle_name": "M. D.",
        "credential": "MSW, LCSW-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WV",
            "license": "BP00944949",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P011427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NATASHA",
            "last_name": "DAVIS",
            "middle_name": "MARIE",
            "credential": "MSW, LGSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maiah Yvonne Moore
• Mary Lisa Moore
• Mecca Moore
• Miranda Y Moore
• Nafeesah Moore, RBT
• Pamela Moore
• Shemina Moore
• Tamara Rochelle Moore, LCSWA, LCASA
• Taquera Moore
• Tessa Deville Moore

• Clinical Social Worker in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.