Individual provider Active NPI

Liani Luisa Moore, LICSW

  • Clinical Social Worker
  • Pawtucket, RI
National Provider Identifier
1962805960
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW04680 Issued in RI
Practice address
1499 Newport Ave
Pawtucket, RI 02861-1342
Phone
(401) 271-6191
Fax
(401) 859-6988
NPI assigned
Oct 3, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LICSW1143055 MA
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X ISW04680 RI Primary

Addresses

Primary practice location

1499 Newport Ave
Pawtucket, RI 02861-1342

Mailing address

PO Box 12
Pawtucket, RI 02862-0012
Phone (401) 271-6191

Other practice location 1

24 Amey St Fl 3
Pawtucket, RI 02860-1107
Phone (401) 271-6191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20260202000434 MA Practitioner - Clinical Social Worker 5294183232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Health Services LLCGroup PAC ID 6901866706, 470 clinicians

Practice addresses (Care Compare)

310 Barnstable Rd
Suite 201
Hyannis, MA 02601-2902
Phone (508) 862-0514

8 N Main St
5TH FL
Attleboro, MA 02703-2282
Phone (508) 409-0000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LICSW1143055MAMDClinical Social Worker
ISW04680RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Health Services, LLC Single Specialty CurrentSince Jan 14, 2026 Accepting new patients
Eva Therapy & Wellness Clinical Current Accepting new patients

Locations

30 Taunton Grn
Ste 5
Taunton, MA 02780
Phone (508) 545-7400

1499 Newport Ave
Pawtucket, RI 02861

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1412294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1962805960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028620012",
            "telephone_number": "401-271-6191",
            "fax_number": "401-859-6988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 NEWPORT AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028611342",
            "telephone_number": "401-271-6191",
            "fax_number": "401-859-6988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 Amey St Fl 3",
            "address_purpose": "LOCATION",
            "city": "Pawtucket",
            "state": "RI",
            "postal_code": "028601107",
            "country_code": "US",
            "telephone_number": "401-271-6191",
            "fax_number": "401-859-6988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LIANI",
        "middle_name": "LUISA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-03",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW1143055",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW04680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

Verify at the official NPI Registry.