Individual provider Active NPI

Monique R Delay-Moore, LCSW

  • Clinical Social Worker
  • Macon, GA
National Provider Identifier
1467697524
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW004960 Issued in GA
Practice address
4116 Arkwright Rd Ste 1
Macon, GA 31210-1707
Phone
(478) 216-5534
Fax
(478) 333-2173
NPI assigned
Dec 3, 2008
Last updated
Feb 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW004960 GA Primary
Community/Behavioral Health Agency 251S00000X 004960 GA

Addresses

Primary practice location

4116 Arkwright Rd Ste 1
Macon, GA 31210-1707

Mailing address

PO Box 6619
Macon, GA 31208-6619
Phone (317) 809-0512

Other practice location 1

109 Osigian Blvd Ste 300
Warner Robins, GA 31088-8924
Phone (478) 333-2411

Other identifiers 1

IdentifierTypeStateIssuer
003163200AMedicaidGA

Other names 1

  • Monique R Moore Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131028001020 GA Practitioner - Clinical Social Worker 2264667302 Reassigns benefits to 1 organization
I20151023001064 GA Practitioner - Clinical Social Worker 2264667302 Practice locations: Macon, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moore Resolutions Group, LLCGroup PAC ID 1052736121, 2 clinicians

Practice addresses (Care Compare)

4100 Riverside Dr
Suite 97
Macon, GA 31210-1848

4116 Arkwright Rd
Suite 1
Macon, GA 31210-1707
Phone (478) 333-2411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW004960GAMDClinical Social Worker
004960GAMDCommunity/Behavioral Health Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Moore Foot and Ankle Solutions, LLC CurrentSince Feb 6, 2022 Accepting new patients
Moore Resolutions Group, LLC Clinical CurrentSince Jul 30, 2020 Accepting new patients
Monique Rechelle Delay Moore Community/Behavioral Health PastSince Sep 23, 2015 Accepting new patients

Locations

4100 Riverside Dr
#97
Macon, GA 31210
Phone (317) 809-0512

4116 Arkwright Rd
#1
Macon, GA 31210
Phone (478) 216-5534

109 Osigian Blvd
Ste 300
Warner Robins, GA 31088
Phone (478) 333-2430

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, 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": "1228262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1467697524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6619",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312086619",
            "telephone_number": "317-809-0512",
            "fax_number": "478-333-2173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4116 ARKWRIGHT RD STE 1",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101707",
            "telephone_number": "478-216-5534",
            "fax_number": "478-333-2173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 Osigian Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310888924",
            "country_code": "US",
            "telephone_number": "478-333-2411",
            "fax_number": "478-333-2173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELAY-MOORE",
        "first_name": "MONIQUE",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-03",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004960",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "004960",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003163200A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MONIQUE",
            "last_name": "MOORE",
            "middle_name": "R",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.