Katrina Rose Moore, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

131530121 Issued in WI

Practice address

3324 Milwaukee St
Madison, WI 53714-1866

Phone

(608) 843-4604

NPI assigned

Jun 18, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Avandra Mental Wellness LLC

  • Clinical Social Worker
  • Madison, WI
  • NPI 1336922558
  Medicare reassignment

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1912567215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 HARDING ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537142218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3324 MILWAUKEE ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537141866",
            "telephone_number": "608-843-4604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2155 E Main St",
            "address_purpose": "LOCATION",
            "city": "Reedsburg",
            "state": "WI",
            "postal_code": "539599440",
            "country_code": "US",
            "telephone_number": "608-415-9956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KATRINA",
        "middle_name": "ROSE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "131530121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Elizabeth Moore, RN
• Chloe M Moore, MSW
• Jaime E. Moore, MS, CFY-SLP
• Kathleen Ann Moore, DPT
• Katie Moore, PSYD
• Khara Moore
• Leyonita Moore, PH.D.
• Mark C Moore, MD
• Mary Moore, CNM
• McKenzie Kuehn Moore, LPC

• Clinical Social Worker in Madison, WI
• Providers in Madison, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2025; 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.