Individual provider Active NPI

Pamela Moen, LISW

  • Clinical Social Worker
  • North Liberty, IA
National Provider Identifier
1447601406
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
081612 Issued in IA
Practice address
1290 Jordan St
North Liberty, IA 52317-8020
Phone
(319) 249-0307
Fax
(319) 358-2367
NPI assigned
Jun 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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 081612 IA Primary

Addresses

Primary practice location

1290 Jordan St
North Liberty, IA 52317-8020

Mailing address

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789
Phone (651) 628-9566

Other practice location 1

1030 5th Ave SE Ste 3000
Cedar Rapids, IA 52403
Phone (319) 286-4545

Other practice location 2

3100 E Ave NW
Cedar Rapids, IA 52405-2962
Phone (800) 531-4236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20210803001982 IA Practitioner - Clinical Social Worker 2365846094 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Meadowlark Partners LLCGroup PAC ID 8921331836, 32 clinicians

Practice addresses (Care Compare)

1290 Jordan St
North Liberty, IA 52317-8020
Phone (319) 432-0531

320 W Cherry St
Meadowlark Psychiatric Services
North Liberty, IA 52317-8819
Phone (319) 626-3300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Associates of Iowa, PC CurrentSince Sep 8, 2025 Accepting new patients
Meadowlark Partners LLC Clinical CurrentSince Jul 20, 2021 Accepting new patients
Psychiatric Associates of Iowa, PC CurrentSince Sep 8, 2025 Accepting new patients

Locations

320 W Cherry St
North Liberty, IA 52317
Phone (319) 626-3300

1290 Jordan St
North Liberty, IA 52317
Phone (319) 356-6352

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1447601406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 JORDAN ST",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523178020",
            "telephone_number": "319-249-0307",
            "fax_number": "319-358-2367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1030 5th Ave SE Ste 3000",
            "address_purpose": "LOCATION",
            "city": "Cedar Rapids",
            "state": "IA",
            "postal_code": "52403",
            "country_code": "US",
            "telephone_number": "319-286-4545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3100 E Ave NW",
            "address_purpose": "LOCATION",
            "city": "Cedar Rapids",
            "state": "IA",
            "postal_code": "524052962",
            "country_code": "US",
            "telephone_number": "800-531-4236",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOEN",
        "first_name": "PAMELA",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "081612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Liberty, IA

Sources for this page

Verify at the official NPI Registry.