Individual provider Active NPI

Cynthia R Moore, APSW

  • Clinical Social Worker
  • Fitchburg, WI
National Provider Identifier
1952047714
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13207-121 Issued in WI
Practice address
5930 Seminole Centre CT Ste C
Fitchburg, WI 53711-5165
Phone
(608) 630-8889
Fax
(608) 200-7268
NPI assigned
May 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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 13207-121 WI Primary

Addresses

Primary practice location

5930 Seminole Centre CT Ste C
Fitchburg, WI 53711-5165

Mailing address

6400 Industrial Loop
Greendale, WI 53129-2452
Phone (414) 858-4106

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13207-121WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
New Beginnings Counseling Center, LLC CurrentSince Aug 1, 2022 Accepting new patients

Locations

5930 Seminole Centre Ct
Ste C
Fitchburg, WI 53711
Phone (608) 630-8889

6400 Industrial Loop
Greendale, WI 53129
Phone (414) 423-4100

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

NPI Registry JSON

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1952047714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 INDUSTRIAL LOOP",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292452",
            "telephone_number": "414-858-4106",
            "fax_number": "414-423-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5930 SEMINOLE CENTRE CT STE C",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537115165",
            "telephone_number": "608-630-8889",
            "fax_number": "608-200-7268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CYNTHIA",
        "middle_name": "R",
        "credential": "APSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "13207-121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.