Individual provider Active NPI

Michelle Moseley, LCSW

  • Clinical Social Worker
  • Malvern, AR
National Provider Identifier
1881636967
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1293-C Issued in AR
Practice address
1628 E Page Ave
Malvern, AR 72104-4524
Phone
(501) 332-4437
NPI assigned
Jun 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1293-C AR Primary

Addresses

Primary practice location

1628 E Page Ave
Malvern, AR 72104-4524

Mailing address

PO Box 1589
Benton, AR 72018-1589
Phone (501) 315-3344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1293-CARMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308614400000",
    "number": "1881636967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1589",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720181589",
            "telephone_number": "501-315-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 E PAGE AVE",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721044524",
            "telephone_number": "501-332-4437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSELEY",
        "first_name": "MICHELLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2011-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "1293-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malvern, AR

Sources for this page

Verify at the official NPI Registry.