Mary B Moonen, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW8791 Issued in FL

Practice address

3653 Cortez Road West
Suite 110a
Bradenton, FL 34210

Phone

(941) 962-6784

Fax

(941) 753-8471

NPI assigned

Mar 23, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mary B Kenific Former name

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1780643072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3653 CORTEZ ROAD WEST",
            "address_2": "SUITE 110A",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34210",
            "telephone_number": "941-962-6784",
            "fax_number": "941-753-8471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3653 CORTEZ ROAD WEST",
            "address_2": "SUITE 110A",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34210",
            "telephone_number": "941-962-6784",
            "fax_number": "941-753-8471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEN",
        "first_name": "MARY",
        "middle_name": "B",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW8791",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "3413",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "KENIFIC",
            "middle_name": "B",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Luis A Montes, MD
• Robert Howes Montgomery, M.D.
• Montiel Dental Care P. a
• Celeste M Montoya, APRN
• Denis Monzin, D.M.D.
• Brittany Moore, M.D.
• Christy Moore, DC
• Donna Lynn Moore, ED.S.
• Jade Lashae Moore, NP
• Kelly Moore

• Clinical Social Worker in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.