Active NPI
Paula Joann Moore, MSW, LCSW
- Clinical Social Worker
- Alton, IL
National Provider Identifier
1790331528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149022555
- Practice address
- Paula J Moore, LCSW
200 W. 3Rd St, Suite 410
Alton, IL 62002-6182 - Phone
- (314) 252-8446
- Fax
- (888) 585-3941
- NPI assigned
- Aug 16, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2017031534 | MO | |
| Clinical Social Worker | 1041C0700X | 149022555 | IL | Primary |
Addresses
Primary practice location
Paula J Moore, LCSW
200 W. 3Rd St, Suite 410
Alton, IL 62002-6182
Mailing address
Paula J Moore, LCSW
200 W. 3Rd St, Suite 410
Alton, IL 62002-6182
Phone (314) 252-8446
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | paulajmoore@protonmail.com | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 149022555 | IL | MD | Clinical Social Worker |
| 2017031534 | MO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713312000000",
"number": "1790331528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PAULA J MOORE, LCSW",
"address_2": "200 W. 3RD ST, SUITE 410",
"city": "ALTON",
"state": "IL",
"postal_code": "620026182",
"telephone_number": "314-252-8446",
"fax_number": "888-585-3941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PAULA J MOORE, LCSW",
"address_2": "200 W. 3RD ST, SUITE 410",
"city": "ALTON",
"state": "IL",
"postal_code": "620026182",
"telephone_number": "314-252-8446",
"fax_number": "888-585-3941"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "PAULA",
"middle_name": "JOANN",
"name_prefix": "Ms.",
"credential": "MSW, LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-16",
"last_updated": "2024-04-17",
"certification_date": "2024-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2017031534",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149022555",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "paulajmoore@protonmail.com",
"affiliation": "N",
"endpointDescription": "Encrypted Business Email address",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "Paula J Moore, LCSW",
"address_2": "200 W. 3rd St, Suite 410",
"city": "Alton",
"state": "IL",
"country_code": "US",
"postal_code": "620026182",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Alton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.