Katherine C Moosally, LISW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1500442-SUPV Issued in OH

Practice address

725 Boardman Canfield Rd
Youngstown, OH 44512-4380

Phone

(330) 330-8655

NPI assigned

Nov 30, 2016

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

Other names 1

• Katherine C Komara Former name

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rajendra P Koirala, M.D., LLCGroup PAC ID 8820334931, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Rajendra P Koirala, M.D., LLC

  • Psychiatry Physician
  • Youngstown, OH
  • NPI 1760977177
  Medicare reassignment Care Compare group
• Mercy Health Physicians Youngstown, LLC

  • Family Medicine Physician
  • Youngstown, OH
  • NPI 1154636066
  NPD (past)

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

{
    "created_epoch": "1480464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1316480866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8905 SOUTH ST SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444842357",
            "telephone_number": "330-787-4719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 BOARDMAN CANFIELD RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445124380",
            "telephone_number": "330-330-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOSALLY",
        "first_name": "KATHERINE",
        "middle_name": "C",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-30",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1500442-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "KOMARA",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tamika Wyndella Moore
• Taryah Deanette Moore
• Tennille Moore
• Yolanda E Moore
• Sherrell Lynn Moorer
• Diamond Morales
• Odessa Morales, PHYSICAL THERAPY
• Steven Morales
• Tiara Christina Morales
• Cheyenne Moran

• Clinical Social Worker in Youngstown, OH
• Providers in Youngstown, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.