Patrice Wallace-Moore, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

042966 Issued in NY

Practice address

75 Seminary Hill Rd
Carmel, NY 10512-1921

Phone

(800) 989-2676

Fax

(845) 704-6178

NPI assigned

Mar 28, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Arms Acres Inc

  • Substance Abuse Rehabilitation Facility
  • Carmel, NY
  • NPI 1447271267
  NPD (past)
• Arms Acres Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Bronx, NY
  • NPI 1649474552
  NPD (past)

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1528187622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 GLENRIDGE RD",
            "city": "GLENVILLE",
            "state": "NY",
            "postal_code": "123024523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 SEMINARY HILL RD",
            "city": "CARMEL",
            "state": "NY",
            "postal_code": "105121921",
            "telephone_number": "800-989-2676",
            "fax_number": "845-704-6178"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 Old Route 6",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "NY",
            "postal_code": "105122107",
            "country_code": "US",
            "telephone_number": "845-225-5202",
            "fax_number": "845-225-0700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACE-MOORE",
        "first_name": "PATRICE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "042966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01420795",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbi Volk, M.D.
• Susan Lynn Vosko, MD,FA.C OG
• Alexandra Nicole Vroman
• Zeah Waldron
• Gordon A Wall
• Christopher J Walpole Jr.
• Danielle Ward, LPN
• Emilia Ward, LCSWR
• Shari D Ward, NP-PSYCHIATRY
• Robyn Weindel

• Clinical Social Worker in Carmel, NY
• Providers in Carmel, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.