Mary Shannon Moore, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

118232 Issued in MA

Practice address

35 John St
Lowell, MA 01852-1101

Phone

(978) 275-3879

Fax

(978) 275-6480

NPI assigned

Jun 2, 2010

Last updated

Nov 13, 2014By 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 1

Addresses

Other names 1

• M. Shannon Moore Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Elliot Community Human Services

  • Community/Behavioral Health Agency
  • Lowell, MA
  • NPI 1669728614
  NPD (past)

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415836800000",
    "number": "1649590563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 JOHN ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018521101",
            "telephone_number": "978-275-3879",
            "fax_number": "978-275-6480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 JOHN ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018521101",
            "telephone_number": "978-275-3879",
            "fax_number": "978-275-6480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARY",
        "middle_name": "SHANNON",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-02",
        "last_updated": "2014-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "118232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "M.",
            "last_name": "MOORE",
            "middle_name": "SHANNON",
            "credential": "LICSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Wander F Montes de Oca Marquez
• George Robert Montminy, OD
• Ashley Moore
• Charlotte A Moore
• Heather Emily Moore, BS
• Sara Moore
• Sonia Morais
• Jonathan Moray, M.D.
• Brittany G Mordarski, DPT
• Jeanette Moreau, MSW, LCSW, M.ED.

• Clinical Social Worker in Lowell, MA
• Providers in Lowell, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2014; 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.