Alexandria Hope Moran

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

132606 Issued in WI

Practice address

750 Veterans Pkwy Unit 100
Lake Geneva, WI 53147-4950

Phone

(262) 248-7942

NPI assigned

Nov 2, 2023

Sex

Female

Sole proprietor

Yes

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

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lake Geneva Wellness Clinic LLCGroup PAC ID 7517139447, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Lake Geneva Wellness Clinic LLC

  • Clinical Psychologist
  • Lake Geneva, WI
  • NPI 1003845181
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1386417244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 RIVERVIEW DR",
            "city": "WATERFORD",
            "state": "WI",
            "postal_code": "531854224",
            "telephone_number": "262-758-9441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 VETERANS PKWY UNIT 100",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531474950",
            "telephone_number": "262-248-7942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "ALEXANDRIA",
        "middle_name": "HOPE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-02",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "132606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Mo, DMD
• Ashlie Moelter
• Mark Joseph Mohapp, LCSW, CSAC
• Anne-Marie Montemayor
• Sarah Raeann Moore, DPT
• Emma Mortensen
• Andrew C. Morton, MD
• Multicultural Health and Wellness, PLLC
• Timothy J Murray, MD
• George Matthew Mussman, MD

• Clinical Social Worker in Lake Geneva, WI
• Providers in Lake Geneva, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.