NPIMap

Organization Active NPI

Jennifer C Moore MSW LCSW Inc

  • Clinical Social Worker
  • Henderson, NV
National Provider Identifier
1962099572
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
JENNIFER C MOORE MSW LCSW INC
Practice address
660 S Green Valley Pkwy Ste 140-150
Henderson, NV 89052-0430
Phone
(702) 240-8639
NPI assigned
Dec 29, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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

Authorized official

Name
Jennifer C MooreNPI 1407977523
Title
Owner/President
Phone
(702) 240-8639

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

660 S Green Valley Pkwy Ste 140-150
Henderson, NV 89052-0430

Mailing address

PO Box 370763
Las Vegas, NV 89137-0763
Phone (702) 240-8639

Other identifiers 1

IdentifierTypeStateIssuer
100511332MedicaidNV

National Provider Directory

National Provider Directory
Tax ID family
Jennifer C Moore MSW LCSW Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610928000000",
    "number": "1962099572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370763",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891370763",
            "telephone_number": "702-240-8639",
            "fax_number": "702-240-6970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 S GREEN VALLEY PKWY STE 140-150",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890520430",
            "telephone_number": "702-240-8639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER C MOORE MSW LCSW INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-29",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "702-240-8639"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100511332",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; 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.