Active NPI
Kylie K Moore, MSW, LSW
- Social Worker
- Sylvania, OH
National Provider Identifier
1609388537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S0800646
- Practice address
- 4913 Harroun Rd Ste 3
Sylvania, OH 43560-2102 - Phone
- (419) 841-3003
- NPI assigned
- Nov 1, 2017
- Last updated
- Nov 1, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S0800646 | OH | Primary |
Addresses
Primary practice location
4913 Harroun Rd Ste 3
Sylvania, OH 43560-2102
Mailing address
2566 Cass Rd
Toledo, OH 43614-4701
Phone (419) 304-8434
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
| License | State | Type | Specialty |
|---|---|---|---|
| S0800646 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1509494400000",
"number": "1609388537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2566 CASS RD",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436144701",
"telephone_number": "419-304-8434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4913 HARROUN RD STE 3",
"city": "SYLVANIA",
"state": "OH",
"postal_code": "435602102",
"telephone_number": "419-841-3003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "KYLIE",
"middle_name": "K",
"credential": "MSW, LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-01",
"last_updated": "2017-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S0800646",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sylvania, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.