Individual provider Active NPI

Tammy J Moghadam, LCSW

  • Mental Health Counselor
  • New Castle, IN
National Provider Identifier
1417280801
Registry record updated Sep 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
34005185A Issued in IN
Practice address
321 S Main St
New Castle, IN 47362-4218
Phone
(765) 529-3370
Fax
(765) 529-7269
NPI assigned
Sep 16, 2009
Last updated
Sep 16, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 34005185A IN Primary

Addresses

Primary practice location

321 S Main St
New Castle, IN 47362-4218

Mailing address

321 S Main St
New Castle, IN 47362-4218
Phone (765) 529-3370

Other identifiers 1

IdentifierTypeStateIssuer
20077810AMedicaidIN

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
34005185AINMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253059200000",
    "number": "1417280801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 S MAIN ST",
            "city": "NEW CASTLE",
            "state": "IN",
            "postal_code": "473624218",
            "telephone_number": "765-529-3370",
            "fax_number": "765-529-7269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 S MAIN ST",
            "city": "NEW CASTLE",
            "state": "IN",
            "postal_code": "473624218",
            "telephone_number": "765-529-3370",
            "fax_number": "765-529-7269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGHADAM",
        "first_name": "TAMMY",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-16",
        "last_updated": "2009-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "34005185A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20077810A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Castle, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2009; 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.