Active NPI
Patrick T Moran, L.C.S.W.
- Clinical Social Worker
- Colorado Springs, CO
National Provider Identifier
1669653853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 991210
- Practice address
- 10 Boulder Crescent St
300C
Colorado Springs, CO 80903-3344 - Phone
- (719) 930-6880
- Fax
- (719) 684-8367
- NPI assigned
- Nov 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 991210 | CO | Primary |
Addresses
Primary practice location
10 Boulder Crescent St
300C
Colorado Springs, CO 80903-3344
Mailing address
PO Box 21
Cascade, CO 80809
Phone (719) 930-6880
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 035635 | Medicaid | CO |
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 |
|---|---|---|---|
| 991210 | CO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470355200000",
"number": "1669653853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 21",
"city": "CASCADE",
"state": "CO",
"postal_code": "80809",
"telephone_number": "719-930-6880",
"fax_number": "719-684-8367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 BOULDER CRESCENT ST",
"address_2": "300C",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809033344",
"telephone_number": "719-930-6880",
"fax_number": "719-684-8367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORAN",
"first_name": "PATRICK",
"middle_name": "T",
"name_prefix": "Mr.",
"credential": "L.C.S.W.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-11-16",
"last_updated": "2016-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "991210",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "035635",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.