Individual provider Active NPI

Rebecca Mores, LICSW

  • Clinical Social Worker
  • Beverly, MA
National Provider Identifier
1407391642
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
116316 Issued in MA
Practice address
145 Cabot St
#4
Beverly, MA 01915-5109
Phone
(508) 333-7818
NPI assigned
Dec 26, 2016
Last updated
Feb 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 116316 MA Primary

Addresses

Primary practice location

145 Cabot St
#4
Beverly, MA 01915-5109

Mailing address

PO Box 404
Salem, MA 01970-0404
Phone (508) 333-7818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
116316MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tides Counseling & Wellness, LLC Current Accepting new patients
Essex County Counseling and Wellness CurrentSince Feb 14, 2021 Accepting new patients

Locations

145 Cabot St
Ste 4
Beverly, MA 01915
Phone 7817183787 ext. 83787

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1482710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1407391642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 404",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019700404",
            "telephone_number": "508-333-7818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 CABOT ST",
            "address_2": "#4",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019155109",
            "telephone_number": "508-333-7818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORES",
        "first_name": "REBECCA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-26",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "116316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.