Destinee Sharae Moore, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149017231 Issued in IL

Practice address

30 N Michigan Ave
Ste 1025
Chicago, IL 60602-3756

Phone

(312) 521-0167

Fax

(708) 843-9384

NPI assigned

Dec 26, 2014

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

Enrolled in IL

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 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1419552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1275921280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 S MICHIGAN AVE UNIT 161",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052408",
            "telephone_number": "312-521-0167",
            "fax_number": "708-843-9384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE",
            "address_2": "STE 1025",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023756",
            "telephone_number": "312-521-0167",
            "fax_number": "708-843-9384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DESTINEE",
        "middle_name": "SHARAE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-26",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149017231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher M Moore, MD
• Claire Eccles Moore, MD
• Danielle Moore, LCSW
• Demerial Moore
• Denis G. Moore, AU.D.
• Duncan Fleming Moore, MD
• Eathel Antoinette Moore, CNA
• Emilee Lane Moore, OTD, OTR/L
• Emily A Moore, CT
• Emily Marie Moore, M.A.

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.