Individual provider Active NPI

Marjorie Doris Moskol, MSW

  • Clinical Social Worker
  • Pawtucket, RI
National Provider Identifier
1477616340
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW00293 Issued in RI
Practice address
28 Roberta Ave
Pawtucket, RI 02860-6142
Phone
(401) 723-3364
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 ISW00293 RI Primary

Addresses

Primary practice location

28 Roberta Ave
Pawtucket, RI 02860-6142

Mailing address

28 Roberta Ave
Pawtucket, RI 02860-6142
Phone (401) 723-3364

Other identifiers 3

IdentifierTypeStateIssuer
412169OtherRIBLUE CHIP OF RI
6245042OtherRIUNITED BEHAVIORAL HEALTH
73871OtherRIBLUE CROSS BLUE SHIELD

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
ISW00293RIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477616340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 ROBERTA AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028606142",
            "telephone_number": "401-723-3364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 ROBERTA AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028606142",
            "telephone_number": "401-723-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSKOL",
        "first_name": "MARJORIE",
        "middle_name": "DORIS",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW00293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP OF RI",
            "identifier": "412169",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "6245042",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "73871",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.