Individual provider Active NPI

Cyrese Marie Moore, LCSW

  • Clinical Social Worker
  • Asheville, NC
National Provider Identifier
1679621775
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C009642 Issued in NC
Practice address
4 Doctors Park Ste H
Asheville, NC 28801-4523
Phone
(828) 285-9911
Fax
(828) 285-9970
NPI assigned
Jan 8, 2007
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW12111 FL
Clinical Social Worker 1041C0700X C009642 NC Primary

Addresses

Primary practice location

4 Doctors Park Ste H
Asheville, NC 28801-4523

Mailing address

1502 W NC Highway 54
Ste 103
Durham, NC 27707-5572
Phone (919) 354-0840

Other practice location 1

1616 Patton Ave
Asheville, NC 28806-1726
Phone (703) 944-6185

Other practice location 2

1616 Patton Ave
Asheville, NC 28806-1726
Phone (703) 944-6185

Other names 1

  • Cyrese Maire Dearing Former name

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

State licenses

LicenseStateTypeSpecialty
SW12111FLMDClinical Social Worker
C009642NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1679621775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 W NC HIGHWAY 54",
            "address_2": "STE 103",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277075572",
            "telephone_number": "919-354-0840",
            "fax_number": "919-748-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 DOCTORS PARK STE H",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288014523",
            "telephone_number": "828-285-9911",
            "fax_number": "828-285-9970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1616 Patton Ave",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288061726",
            "country_code": "US",
            "telephone_number": "703-944-6185",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1616 Patton Ave",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288061726",
            "country_code": "US",
            "telephone_number": "703-944-6185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CYRESE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12111",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYRESE",
            "last_name": "DEARING",
            "middle_name": "MAIRE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Asheville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.