Active NPI
Angela Marie Moore, LISW
- Clinical Social Worker
- Worthington, OH
National Provider Identifier
1326285107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I.1700308
- Practice address
- 455 E Dublin Granville Rd
Suite G
Worthington, OH 43085-3126 - Phone
- (740) 344-4056
- NPI assigned
- Jan 15, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | S0800831 | OH | |
| Clinical Social Worker | 1041C0700X | I.1700308 | OH | Primary |
Addresses
Primary practice location
455 E Dublin Granville Rd
Suite G
Worthington, OH 43085-3126
Mailing address
455 E Dublin Granville Rd
Suite G
Worthington, OH 43085-3126
Phone (740) 334-4056
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0200008 | Medicaid | OH |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S0800831 | OH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492387200000",
"number": "1326285107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 E DUBLIN GRANVILLE RD",
"address_2": "SUITE G",
"city": "WORTHINGTON",
"state": "OH",
"postal_code": "430853126",
"telephone_number": "740-334-4056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "455 E DUBLIN GRANVILLE RD",
"address_2": "SUITE G",
"city": "WORTHINGTON",
"state": "OH",
"postal_code": "430853126",
"telephone_number": "740-344-4056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "ANGELA",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-15",
"last_updated": "2017-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "S0800831",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I.1700308",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0200008",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Worthington, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.