Jennifer Moore, LCSW
Individual provider Active NPI Clinical Social Worker · Kane, PA
NPI 1700320322 · NPPES record last updated Jul 28, 2021
Key facts
- NPI
- 1700320322
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- CW020261 (PA)
- Practice address
- 9 Field St
Kane, PA 16735-1322 - Phone
- (814) 561-1028
- NPI assigned
- Dec 16, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
9 Field St
Kane, PA 16735-1322
Phone (814) 561-1028
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190130001859 | PA | Practitioner - Clinical Social Worker | 3678810520 | Practice locations: Kane, PA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW133268 | PA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jennifer Moore, LCSW Counseling Services | Clinical | Current |
Accepting new patients |
Locations
9 Field St
Kane, PA 16735
Phone (814) 561-1028
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | SW133268 | PA | |
| Clinical Social Worker | 1041C0700X | CW020261 | PA | Yes |
Addresses
Primary practice location
9 Field St
Kane, PA 16735-1322
Mailing address
9 Field St
Kane, PA 16735-1322
Phone (181) 558-5635
Other practice location 1
1048 Pennsylvania Ave W
Warren, PA 16365-1838
Phone (814) 230-9111
Other practice location 2
589 Hospital Dr
Suite E
Warren, PA 16365-4875
Phone (814) 723-1330 ext. 110
Other providers in Kane, PA
- Erin Mary McMahon
- Medicine Shoppe
- Milestones Physical Therapy, LLC
- Monica Miller
- Sandra Kay Mishic
- Pediatric Services of America, LLC
- Hairong Peng
- Penn Highlands Home Medical Equipment LLC
- Penn North Centers for Advanced Wound Care Inc
- Daniel F Perri
All providers in Kane, PA · Clinical Social Worker in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.