Blaine Moore, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

50464 Issued in TX

Practice address

601 S Main St
Mansfield, TX 76063-3112

Phone

(817) 914-2267

NPI assigned

Feb 1, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Moore Counseling and Wellness, Inc.

  • Clinical Social Worker
  • Mansfield, TX
  • NPI 1609234434
  NPD Authorized official
• Fort Worth Brief Therapy Center, PLLC

  • Professional Counselor
  • Ft Worth, TX
  • NPI 1417295445
  NPD (past)

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1346388659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S MAIN ST",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633112",
            "telephone_number": "817-914-2267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S MAIN ST",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633112",
            "telephone_number": "817-914-2267"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3840 Hulen St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761077277",
            "country_code": "US",
            "telephone_number": "817-335-3022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "BLAINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "50464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelley L Monroe, PMHNP-BC
• La Shanda Montgomery, MSN, RN, FNP-C
• Robert Montoya, APRN
• Ashley Moon, LPC
• Moore Counseling and Wellness, Inc.
• Curtiss Moore
• Gregory Todd Moore, DO
• Lindsay Moore, MS CCC/SLP
• Natashia Sunita Moore, LCSW
• Tyanna Moore

• Clinical Social Worker in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; 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.