Individual provider Active NPI

Shawna Moss, LCSW

  • Clinical Social Worker
  • Round Rock, TX
National Provider Identifier
1609151166
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
60019 Issued in TX
Practice address
425 University Blvd
Round Rock, TX 78665-1047
Phone
(512) 509-0200
NPI assigned
Oct 17, 2011
Last updated
Oct 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 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 CSW004159 GA
Clinical Social Worker 1041C0700X 60019 TX Primary

Addresses

Primary practice location

425 University Blvd
Round Rock, TX 78665-1047

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smoss1092654@direct.sw.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150710000056 TX Practitioner - Clinical Social Worker 4385956945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15901 Central Commerce Dr
Suite 104
Pflugerville, TX 78660-2042
Phone (512) 979-6708

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW004159GAMDClinical Social Worker
60019TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Current Accepting new patients
Pinnacle Therapeutic Services, PLLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

15901 Central Commerce Dr
Ste 104
Pflugerville, TX 78660
Phone (512) 979-6708

425 University Blvd
Round Rock, TX 78665
Phone (512) 509-0100

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

Interoperability endpoints

  • Direct secure messaging: smoss1092654@direct.sw.org

Organizations & group practices 2

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": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1609151166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 UNIVERSITY BLVD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651047",
            "telephone_number": "512-509-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "SHAWNA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-17",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004159",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "60019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smoss1092654@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "425 University Blvd",
            "city": "Round Rock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786651047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.