Kelly C Moore, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

008397 Issued in IA

Practice address

4923 Lincoln Way Ste 102
Ames, IA 50014-3616

Phone

(515) 368-7050

Fax

(515) 206-9039

NPI assigned

May 16, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Blooming Heart Counseling

  • Clinical Social Worker
  • Ames, IA
  • NPI 1184587297
  NPD Authorized official

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1689021164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4923 LINCOLN WAY STE 102",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500143616",
            "telephone_number": "515-368-7050",
            "fax_number": "515-206-9039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4923 LINCOLN WAY STE 102",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500143616",
            "telephone_number": "515-368-7050",
            "fax_number": "515-206-9039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KELLY",
        "middle_name": "C",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-16",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "008397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanna Barbara Moore, PHARMD
• David Brian Moore, M.D.
• David Dean Moore III, MD
• Jacob B Moore, DPT
• John Richard Moore, D.C.
• Alicia S Moos, M.A., CCC-SLP
• Coraima Morales
• Jason Ty Moreno
• Sarah L Moreno
• Ashlie Marie Morgan

• Clinical Social Worker in Ames, IA
• Providers in Ames, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; 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.