Taraka Taylor-Moultrie, LISW-CP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

14372 Issued in SC

Practice address

780 Charter Dr Unit B11
Longs, SC 29568-5833

Phone

(478) 361-2126

NPI assigned

Jun 11, 2021

Sex

Female

Sole proprietor

Yes

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

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Musc Community Physicians

  • Internal Medicine Physician
  • Bamberg, SC
  • NPI 1841878006
  Medicare reassignment NPD
• Bridging the Gap Wellness Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Longs, SC
  • NPI 1194430660
  NPD Authorized official
• Musc Community Physicians

  • Rural Health Clinic/Center
  • Bowman, SC
  • NPI 1225735772
  NPD

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1720656291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 CHARTER DR UNIT B11",
            "city": "LONGS",
            "state": "SC",
            "postal_code": "295685833",
            "telephone_number": "478-361-2126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 CHARTER DR UNIT B11",
            "city": "LONGS",
            "state": "SC",
            "postal_code": "295685833",
            "telephone_number": "478-361-2126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR-MOULTRIE",
        "first_name": "TARAKA",
        "credential": "LISW-CP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-11",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "14372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roulons
• Jane Seitz, MOT, OTR/L
• Speech by the Beach Inc
• Latonya Stanley
• Ronald Tapp, RPH
• Melanie Clarito Taylor, RN
• Dylan Parker Todd
• Total Renal Care Inc
• Romi Trabolsky
• Kenneth Ray Warrick, M.D.

• Clinical Social Worker in Longs, SC
• Providers in Longs, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.