Stephanie J Moon

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089704 Issued in NY

Practice address

3100 47TH Ave Ste 3100
Long Island City, NY 11101-3050

Phone

(888) 684-2779

NPI assigned

Oct 7, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1861099426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 47TH AVE STE 3100",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111013050",
            "telephone_number": "888-684-2779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 47TH AVE STE 3100",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111013050",
            "telephone_number": "888-684-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "STEPHANIE",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "089704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AFFILIATED TO ANOTHER ORGANIZATION",
            "identifier": "1437585882",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Beth Montag
• Gandhy Magally Montalvo Rosales, MD
• Bruna Monteau, RN
• Maria Montes, LMHC
• Jerry Montgomery, RN
• Sanna A Moore, LCSW
• Ana Morales, LCSW, MPA
• John Morales, PTA
• Madeline L Morales
• Minerva Morales

• Clinical Social Worker in Long Island City, NY
• Providers in Long Island City, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.