Active NPI
Sederia Ellen Moore
- Clinical Social Worker
- Austin, TX
National Provider Identifier
1669965356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 66008
- Practice address
- 7600 Wood Hollow Dr Apt 111
Austin, TX 78731-2242 - Phone
- (747) 777-0503
- NPI assigned
- Jun 7, 2018
- Sex
- Female
- 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 | 66008 | TX | Primary |
Addresses
Primary practice location
7600 Wood Hollow Dr Apt 111
Austin, TX 78731-2242
Mailing address
3320 173Rd PL NE
Arlington, WA 98223-8712
Other practice location 1
2015 Cedar Bend Dr Apt 331
Austin, TX 78758-5340
Phone (747) 777-0503
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Airedescent Wellness, PLLC | Clinical | Current | Accepting new patients |
| Shine Medical Providers PC | Single Specialty | Past | Accepting new patients |
| Uplift Behavioral Health PC | Clinical | Past | Accepting new patients |
| Shine Medical of Ca PC | Single Specialty | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Social Worker
- Austin, TX
- NPI 1841887510
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661644800000",
"number": "1669965356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3320 173RD PL NE",
"city": "ARLINGTON",
"state": "WA",
"postal_code": "982238712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7600 WOOD HOLLOW DR APT 111",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787312242",
"telephone_number": "747-777-0503"
}
],
"practiceLocations": [
{
"address_1": "2015 Cedar Bend Dr Apt 331",
"address_purpose": "LOCATION",
"city": "Austin",
"state": "TX",
"postal_code": "787585340",
"country_code": "US",
"telephone_number": "747-777-0503",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOORE",
"first_name": "SEDERIA",
"middle_name": "ELLEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-07",
"last_updated": "2022-08-28",
"certification_date": "2022-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "66008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.