Mary Moore LCSW-C LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MARY MOORE LCSW-C LLC

Practice address

49 Old Solomons Island Rd
Suite 200
Annapolis, MD 21401-3854

Phone

(410) 980-3155

Fax

(410) 266-5328

NPI assigned

Jul 14, 2011

Last updated

Jan 6, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mary Moore, LCSW-CNPI 1316234750

Title

Owner

Phone

(410) 980-3155

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Moore, LCSW-C

  • Clinical Social Worker
  • Edgewater, MD
  • NPI 1316234750
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452038400000",
    "number": "1366730103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 OLD SOLOMONS ISLAND RD",
            "address_2": "SUITE 200",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013854",
            "telephone_number": "410-980-3155",
            "fax_number": "410-266-5328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 OLD SOLOMONS ISLAND RD",
            "address_2": "SUITE 200",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013854",
            "telephone_number": "410-980-3155",
            "fax_number": "410-266-5328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY MOORE LCSW-C LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-14",
        "last_updated": "2016-01-06",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-980-3155",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.