Ryan Moore

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0906017010 Issued in VA

Practice address

1318 Jamestown Rd Ste 102
Williamsburg, VA 23185-3382

Phone

(757) 231-5576

Fax

(757) 834-8861

NPI assigned

Sep 13, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Mission Mind Wellness, LLC

  • Clinical Social Worker
  • Williamsburg, VA
  • NPI 1144937541

  Addiction (Substance Use Disorder)

  NPD Authorized official

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

{
    "created_epoch": "1757721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757721600000",
    "number": "1821969916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 JAMESTOWN RD STE 102",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231853382",
            "telephone_number": "757-231-5576",
            "fax_number": "757-834-8861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 JAMESTOWN RD STE 102",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231853382",
            "telephone_number": "757-231-5576",
            "fax_number": "757-834-8861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "RYAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-13",
        "last_updated": "2025-09-13",
        "certification_date": "2025-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0709026539",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0906017010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lehman Montgomery Jr.
• Michael Salvatore Montileone, MD
• Elizabeth M Moore, FNP-C
• Jesalyn Moore, LCSW, LSATP, CAADC
• Lori Nicole Moore, NP
• Morgan Walker, PHD, LPC, NCC, LLC
• Alexa Joy Morgan, FNP
• Nicholas Michael Morgan, FNP-C
• Sharon Morgan
• Zachary Alexander Morie, DO

• Clinical Social Worker in Williamsburg, VA
• Providers in Williamsburg, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.