Jordan Moore, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

119596 Issued in MA

Practice address

40 Holland St
Somerville, MA 02144-2705

Phone

(617) 629-6000

NPI assigned

Jul 20, 2016

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1932552478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "287 HURON AVE",
            "address_2": "#2",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021381303",
            "telephone_number": "843-532-9389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 HOLLAND ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442705",
            "telephone_number": "617-629-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JORDAN",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-20",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "119596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghan L Montgomery, LMHC
• Keri A Monuteaux
• Allison Moody, PA-C
• Heather W Moon, M.A.
• Derek Dykes Moore, LICSW
• Leon Moore
• April Emily Moorer
• Aaron Morales
• Donald F Moran, M.D.
• Tracy Moreland, CASE MANAGER/CSP

• Clinical Social Worker in Somerville, MA
• Providers in Somerville, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.