M. Lise Moulton, L.I.S.W.

Primary specialty

Social WorkerTaxonomy code 104100000X

License

I-0004208 Issued in OH

Practice address

5105 Som Center Rd
Willoughby, OH 44094-4203

Phone

(216) 621-5600

Fax

(216) 479-5554

NPI assigned

Sep 1, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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 names 1

• Ms. Mary Elizabeth Kern Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619079886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 LAKESIDE AVE E",
            "address_2": "#1200",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441141158",
            "telephone_number": "216-479-5541",
            "fax_number": "216-479-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5105 SOM CENTER RD",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440944203",
            "telephone_number": "216-621-5600",
            "fax_number": "216-479-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULTON",
        "first_name": "M.",
        "middle_name": "LISE",
        "name_prefix": "Ms.",
        "credential": "L.I.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I-0004208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "KERN",
            "middle_name": "ELIZABETH",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Morris W. Levinsohn, M.D., Inc.
• Apryl Morris
• Dwauna Morrow
• Beth Motta
• Kimberly Moulton
• Susan M Moyer, P.A.
• Kimberly Mulhall
• Alex Mullen, DVM
• Mona Sue Murphy, RN, SCHOOL NURSE
• Paul Sean Murphy, DDS, MSD

• Social Worker in Willoughby, OH
• Providers in Willoughby, OH by specialty
• Social Worker in Ohio

• 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.