Active NPI
Joanne Moran, RN,LICSW
- Clinical Social Worker
- Brighton, MA
National Provider Identifier
1306901558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1019800
- Practice address
- 17 Henshaw St
Brighton, MA 02135-2905 - Phone
- (617) 782-0063
- NPI assigned
- Dec 27, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1019800 | MA | Primary |
Addresses
Primary practice location
17 Henshaw St
Brighton, MA 02135-2905
Mailing address
17 Henshaw St
Brighton, MA 02135-2905
Phone (617) 782-0063
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8332-01 | Other | MA | PACIFICCARE |
| 718468 | Other | MA | TUFTS HEALTH PLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1019800 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306901558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 HENSHAW ST",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "021352905",
"telephone_number": "617-782-0063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 HENSHAW ST",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "021352905",
"telephone_number": "617-782-0063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORAN",
"first_name": "JOANNE",
"credential": "RN,LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "1019800",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PACIFICCARE",
"identifier": "8332-01",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "718468",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brighton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.