Individual provider Active NPI

Nancy L Moran, LCSW

  • Clinical Social Worker
  • Huntington, NY
National Provider Identifier
1275644965
Registry record updated Feb 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R-075909-1 Issued in NY
Practice address
55 Horizon Dr
Huntington, NY 11743-4436
Phone
(631) 920-8000
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2013

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 R-075909-1 NY Primary

Addresses

Primary practice location

55 Horizon Dr
Huntington, NY 11743-4436

Mailing address

62 Oakdale Rd
Centerport, NY 11721-1531
Phone (631) 871-7316

Other identifiers 1

IdentifierTypeStateIssuer
07300075909MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, RI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181221002366 NY Practitioner - Clinical Social Worker 9931444775 Reassigns benefits to 2 organizations
I20260114002155 RI Practitioner - Clinical Social Worker 9931444775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Shore Child Association IncorporatedGroup PAC ID 0648550822, 6 clinicians

Practice addresses (Care Compare)

114 Church St
Freeport, NY 11520-3833
Phone (516) 868-3030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R-075909-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Child Association Incorporated CurrentSince Mar 1, 2018 Accepting new patients
Newport County Community Mental Health Center, Inc CurrentSince Oct 24, 2025 Accepting new patients

Locations

114 Church St
Freeport, NY 11520
Phone (516) 868-3030

91 Guy Lombardo Ave
Fl 2
Freeport, NY 11520
Phone (516) 868-3030

65 Valley Rd
Middletown, RI 02842
Phone (401) 431-9870

42 Valley Rd
Middletown, RI 02842
Phone (401) 843-1213

Organizations & group practices 3

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359763200000",
    "number": "1275644965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 OAKDALE RD",
            "city": "CENTERPORT",
            "state": "NY",
            "postal_code": "117211531",
            "telephone_number": "631-871-7316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 HORIZON DR",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117434436",
            "telephone_number": "631-920-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "NANCY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2013-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R-075909-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07300075909",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.