Melbourne Richard Moran Jr., M.S.W

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

120381 Issued in MA

Practice address

400 Amherst St Ste 200
Nashua, NH 03063-4223

Phone

(603) 889-3553

Fax

(603) 589-4981

NPI assigned

Oct 14, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MA, NH, WA3 enrollments

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 3

Specialty

Clinical Social Worker

Education

Boston University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wanderlust Therapeutic Services PLLCGroup PAC ID 7012322753, 13 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.

• Wanderlust Therapeutic Services, PLLC

  • Clinical Social Worker
  • Nashua, NH
  • NPI 1225659600

  MA, WA

  Medicare reassignment Care Compare group NPD Authorized official
• Bridgewell, Inc

  • Community/Behavioral Health Agency
  • Lowell, MA
  • NPI 1033262860
  Medicare reassignment NPD
• Bridgewell Counseling Services

  • Community/Behavioral Health Agency
  • Chelmsford, MA
  • NPI 1326469867
  NPD (past)

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1871997379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 AMHERST ST STE 200",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030634223",
            "telephone_number": "603-889-3553",
            "fax_number": "603-589-4981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 AMHERST ST STE 200",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030634223",
            "telephone_number": "603-889-3553",
            "fax_number": "603-589-4981"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 Fletcher St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Lowell",
            "state": "MA",
            "postal_code": "018544312",
            "country_code": "US",
            "telephone_number": "603-889-3553",
            "fax_number": "603-589-4981",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "889 Elm St Fl 5",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "031012019",
            "country_code": "US",
            "telephone_number": "603-889-3553",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "312 SE Stonemill Dr Ste 135",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986843508",
            "country_code": "US",
            "telephone_number": "603-889-3553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORAN",
        "first_name": "MELBOURNE",
        "middle_name": "RICHARD",
        "name_suffix": "Jr.",
        "credential": "M.S.W",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-14",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "61312959",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "120381",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "2094",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mel@wanderlustservices.org",
            "affiliation": "N",
            "endpointDescription": "secure email",
            "address_1": "97 Central St Ste 205A",
            "city": "Lowell",
            "state": "MA",
            "country_code": "US",
            "postal_code": "018521943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Judith Nancy Montmarquette, APRN, BC, FNP
• Montshire Nashua PC
• Tajah Moody-Whitley
• Bobbilyn Catherine Moore
• Tara Leigh Moore, FNP
• Claire M Morehouse
• Susan O Morelli, SLP
• Carolyn Morgan, PH.D.
• Evan Morgan
• Marlene S Morgan, SLP

• Clinical Social Worker in Nashua, NH
• Providers in Nashua, NH by specialty
• Clinical Social Worker in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.
• 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.