Jessica Moore

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

A14777 Issued in OR

Practice address

1060 Webber St
The Dalles, OR 97058-3749

Phone

(541) 296-5452

NPI assigned

Oct 30, 2023

Sex

Female

Sole proprietor

No

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

Enrolled in OR

Eligible to order & refer

• Part B services: No
• 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

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.

• Mindful Therapy Group PC

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678

  Mental Health, OR

  Medicare reassignment NPD
• Mid-Columbia Center for Living

  • Community/Behavioral Health Agency
  • The Dalles, OR
  • NPI 1275954513
  NPD
• Mid-Columbia Center for Living

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • The Dalles, OR
  • NPI 1699745794
  NPD

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

{
    "created_epoch": "1698624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1831962141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 WEBBER ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583749",
            "telephone_number": "541-296-5452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 WEBBER ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583749",
            "telephone_number": "541-296-5452"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11740 SW 68th Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972239058",
            "country_code": "US",
            "telephone_number": "425-678-6463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-30",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "A14777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mobility Systems LLC
• Cheryl Mojzer
• Shantill Lynn Moody
• Kyle Kathleen Moon
• Paul Oh Sung Moon, M.D.
• Kathleen Baker Moore, M.D.
• Elizabeth A Morales Davila
• Mireya Moreno Ibarra
• Ana Lucia Moreno, M.D.
• Coleen C. Moreno, LCSW, LICSW

• Clinical Social Worker in The Dalles, OR
• Providers in The Dalles, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.