Latrisha Mooberry, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

149022593 Issued in IL

Practice address

385 E Idlewood St
Morton, IL 61550-2891

Phone

(309) 270-5425

NPI assigned

Oct 9, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Chapters Counseling PLLC

  • Clinical Social Worker
  • Morton, IL
  • NPI 1588321434
  NPD Authorized official

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1336747633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 E IDLEWOOD ST",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615502891",
            "telephone_number": "309-263-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 E IDLEWOOD ST",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615502891",
            "telephone_number": "309-270-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOBERRY",
        "first_name": "LATRISHA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-09",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "149022593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "364276135",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Merila
• Ron Messner, MSW
• Amber Miller
• Brittany Miller
• Victoria L Mitchell, LCSW
• Courtney Leigh Morse
• Morton Alwan Pharmacy LLC
• Morton Alwan Pharmacy LLC
• Morton Audiology Inc
• Morton Community Unit Dist 709

• Social Worker in Morton, IL
• Providers in Morton, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; 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.