Gwendolyn Sheunta Moore, BSW,LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P018833 Issued in NC

Practice address

120 Health Center Dr
Ahoskie, NC 27910-8161

Phone

(252) 332-3548

NPI assigned

May 16, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: dreamprovidercareservicesinc.gwendolynsheuntamoore@158148.advancedmd-direct.com

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

{
    "created_epoch": "1684195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1457042962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 CHAMBLEE AVE",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279109761",
            "telephone_number": "252-326-0764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HEALTH CENTER DR",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279108161",
            "telephone_number": "252-332-3548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "GWENDOLYN",
        "middle_name": "SHEUNTA",
        "credential": "BSW,LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-16",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P018833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Minton RX Inc
• Minton RX, Inc
• Edouard Misse', M.D.
• Alicia L Mitchell
• Lorraine Chavis Mitchell, MASTER'S
• Morning Star Women Health Center Inc
• Teresa Lanier Morris, FNP-BC
• Adrian Mosqueda, PT
• Emma Cora Mutcher, DMD
• Gilberto Pabalan Navarro, MD

• Clinical Social Worker in Ahoskie, NC
• Providers in Ahoskie, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; 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.