Caroline Moore, PH.D., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

87033 Issued in CA

Practice address

1718 Le Roy Ave
Berkeley, CA 94709-1116

Phone

(602) 430-8306

Fax

(917) 591-7417

NPI assigned

Oct 17, 2012

Last updated

Jun 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1528311404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 LE ROY AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947091116",
            "telephone_number": "602-430-8306",
            "fax_number": "917-591-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 LE ROY AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947091116",
            "telephone_number": "602-430-8306",
            "fax_number": "917-591-7417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "242 E 72nd St",
            "address_2": "Suite 1A",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100214574",
            "country_code": "US",
            "telephone_number": "212-365-0755",
            "fax_number": "917-591-7417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CAROLINE",
        "credential": "PH.D., LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-17",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "075903-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "87033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsie Moody
• Destini Renee Moody, MS, RD, CSSD
• Olivia Cecelia Moody, AMFT
• Amy Lynn Moore, PSY.D
• Anna Moore, ASW
• Ellen Moore, LCSW
• Emily Lorraine Fisher Moore, NP, RN
• Koala Bear Moore, L.AC.
• Teresa Mary Moore, MS, NCC
• Heather Chandler Moorhead, MSW

• Clinical Social Worker in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.