Bobbi L Moon, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8942-C Issued in AR

Practice address

19 E Mountain St Ste 33
Fayetteville, AR 72701-6067

Phone

(479) 530-6678

NPI assigned

Jul 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Home Body Holistic Studio LLC

  • Clinical Social Worker
  • Fayetteville, AR
  • NPI 1750128948
  NPD Authorized official

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

{
    "created_epoch": "1532649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1346727799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 E MOUNTAIN ST STE 33",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727016067",
            "telephone_number": "479-530-6678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 E MOUNTAIN ST STE 33",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727016067",
            "telephone_number": "479-530-6678"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 N College Ave Ste 5",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "727015343",
            "country_code": "US",
            "telephone_number": "479-396-8806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOON",
        "first_name": "BOBBI",
        "middle_name": "L",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-27",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "8942-M",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "8942-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherrie Kay Montellano, PA-C
• Anne Gaston Montgomery, M.D.
• Clarice Montgomery, PHARMD
• Janet K Montgomery, SLP
• Roger C Montgomery, M.D.
• Karen Melissa Moon, LCSW
• Tiffany Mooney, D.P.T
• Mandy Suzanne Mooneyham, PA-C
• Aleigh Marie Moore-Masterson, BT
• Andrew Moore

• Clinical Social Worker in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.