Mia Moore Kirby, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

55533 Issued in TX

Practice address

9330 Lyndon B. Johnson Fwy. #900
Dallas, TX 75243

Phone

(972) 861-0106

Fax

(505) 814-5737

NPI assigned

Jul 25, 2009

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 identifiers 1

Other names 1

• Mia Moore Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1248480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1285864165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 RIVERWALK LANE",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "75063",
            "telephone_number": "972-861-0106",
            "fax_number": "505-814-5737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9330 LYNDON B. JOHNSON FWY. #900",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75243",
            "telephone_number": "972-861-0106",
            "fax_number": "505-814-5737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRBY",
        "first_name": "MIA",
        "middle_name": "MOORE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-25",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "55533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11992198",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIA",
            "last_name": "MOORE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexis Kirby
• Donna June Kirby, M.S., LPC-S
• Joshua Kirby, PHD
• Judith A Kirby, M.D., F.A.C.S.
• Kristen Suzanne Kirby, MS, APRN, FNP-C
• Michelle Angela Kirby, SLP INTERN
• Quintolyn Kirby
• Randall Parker Kirby, M.D., F.A.C.S.
• Stephen Wayne Kircher, MD
• Amy Kirchhoff, LPC

• Clinical Social Worker in Dallas, TX
• Providers in Dallas, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; 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.