Individual provider Active NPI

Latrionna Moore, LSW

  • Clinical Social Worker
  • Westmont, IL
National Provider Identifier
1891404513
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.030362 Issued in IL
Practice address
414 Plaza Dr Ste 301
Westmont, IL 60559-5508
Phone
(630) 728-1744
NPI assigned
Nov 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2026

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 149.030362 IL Primary

Addresses

Primary practice location

414 Plaza Dr Ste 301
Westmont, IL 60559-5508

Mailing address

414 Plaza Dr Ste 301
Westmont, IL 60559-5508
Phone (630) 728-1744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20251208002401 IL Practitioner - Clinical Social Worker 5395198113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2500 S Highland Ave
Suite 325
Lombard, IL 60148-5390

414 Plaza Dr
Suite 301
Westmont, IL 60559-1216

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.030362ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Integrated, LLC CurrentSince Nov 25, 2025 Accepting new patients

Locations

2500 S Highland Ave
Ste 325
Lombard, IL 60148
Phone (630) 495-9810

125 Windsor Dr
Ste 113
Oak Brook, IL 60523
Phone (630) 728-1744

414 Plaza Dr
Ste 301
Westmont, IL 60559
Phone (630) 728-1744

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1891404513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 PLAZA DR STE 301",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595508",
            "telephone_number": "630-728-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 PLAZA DR STE 301",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595508",
            "telephone_number": "630-728-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LATRIONNA",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-21",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.030362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westmont, IL

Sources for this page

Verify at the official NPI Registry.