Individual provider Active NPI

Mai Ku Moua, MSW, LCSW

  • Clinical Social Worker
  • Concord, NC
National Provider Identifier
1629982079
Registry record updated Oct 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C011090 Issued in NC
Practice address
301 Medical Park Dr Ste 202B
Concord, NC 28025-3059
Phone
(763) 843-9604
NPI assigned
Oct 1, 2026
Last updated
Oct 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C011090 NC Primary

Addresses

Primary practice location

301 Medical Park Dr Ste 202B
Concord, NC 28025-3059

Mailing address

301 Medical Park Dr Ste 202B
Concord, NC 28025-3059
Phone (763) 843-9604

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790812800000",
    "number": "1629982079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MEDICAL PARK DR STE 202B",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253059",
            "telephone_number": "763-843-9604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MEDICAL PARK DR STE 202B",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253059",
            "telephone_number": "763-843-9604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUA",
        "first_name": "MAI",
        "middle_name": "KU",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-01",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C011090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.