Jennifer De'Shae Moore, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

64153 Issued in TX

Practice address

1735 Keller Springs Rd Ste 202
Carrollton, TX 75006-3006

Phone

(888) 472-2192

NPI assigned

Nov 20, 2023

Last updated

Sep 18, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in TX

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Assurasource LTD

  • Clinical Social Worker
  • Plano, TX
  • NPI 1194746016
  Medicare reassignment NPD
• Senior Psychological Care Dallas I, LLC

  • Psychologist
  • Houston, TX
  • NPI 1649566795

  Clinical

  Medicare reassignment NPD
• Connections Wellness Group

  • Mental Health Counselor
  • Plano, TX
  • NPI 1003398421
  Medicare reassignment

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1922873926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 KELLER SPRINGS RD STE 202",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750063006",
            "telephone_number": "888-472-2192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 KELLER SPRINGS RD STE 202",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750063006",
            "telephone_number": "888-472-2192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JENNIFER",
        "middle_name": "DE'SHAE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-20",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "64153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aja Moore, LMSW
• Anastasia Moore
• Brittany Moore, BSN, RN, CA-CP SANE
• Carlotta Marie Moore
• Geneava Moore
• Julie E Moore, D.D.S.
• Neecie Moore, PHD, LPC, LMFT
• Conrad Mooter
• Gregory Charles Moran, MD
• Laura Vondra Morath, O.D.

• Clinical Social Worker in Carrollton, TX
• Providers in Carrollton, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.