Elizabeth C Irwin Moore, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6763-123 Issued in WI

Practice address

1220 Dewey Ave
BLDG #3
Wauwatosa, WI 53213

Phone

(414) 454-6566

Fax

(414) 454-6522

NPI assigned

Aug 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Elizabeth C Irwin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Manitowoc, WI
  • NPI 1801941075
  NPD (past)
• Aurora Psychiatric Hospital, Inc.

  • Psychiatric Hospital
  • Wauwatosa, WI
  • NPI 1881627438
  NPD (past)

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189555200000",
    "number": "1447368162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 DEWEY AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532132504",
            "telephone_number": "414-454-6779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 DEWEY AVE",
            "address_2": "BLDG #3",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "53213",
            "telephone_number": "414-454-6566",
            "fax_number": "414-454-6522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRWIN MOORE",
        "first_name": "ELIZABETH",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "6763-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40912000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "IRWIN",
            "middle_name": "C",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Integrated Spine Care, S.C.
• Interventional Procedures Group LTD
• Intrasage Therapy LLC
• Nikhath Irfana, M.D
• Iris Manor
• Chelsey Isaacson, CPM
• Peter J Isely, LCSW
• Annamaria Iskandarani
• Alicia Ivory, MD
• J.L. Mackman DDS

• Clinical Social Worker in Wauwatosa, WI
• Providers in Wauwatosa, 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 Sep 12, 2007; 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.