Jaclyn Mary Moore, LMSW, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

2023013705 Issued in MO

Practice address

150 Saint Peters Centre Blvd Ste B
Saint Peters, MO 63376-1653

Phone

(636) 466-8497

NPI assigned

Apr 19, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jaclyn Mary Karman 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": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1306533484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2673 RUDDY RIDGE DR",
            "city": "HIGH RIDGE",
            "state": "MO",
            "postal_code": "630493709",
            "telephone_number": "630-818-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SAINT PETERS CENTRE BLVD STE B",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761653",
            "telephone_number": "636-466-8497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JACLYN",
        "middle_name": "MARY",
        "credential": "LMSW, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-19",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.109222",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2023013705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "KARMAN",
            "middle_name": "MARY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kimberly Ann Moler, DPT
• Michael Jason Molohon, LPC
• Emily Monfre, M.A, BCBA. LBA
• Kasey Montgomery
• Charles Mooneyham
• Miranda Paton Moore, DC
• Megan Moriarity
• Janna Marie Morley
• Morningstar Neuropathy & Pain Treatment Center LLC
• Mark Vincent Morrell, D.D.S. M.S

• Social Worker in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.