Active NPI
Shirley L. Moore
- Clinical Social Worker
- Kalamazoo, MI
National Provider Identifier
1972930808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801099162
- Practice address
- 625 Harrison St
Kalamazoo, MI 49007-3681 - Phone
- (269) 323-1954
- Fax
- (269) 323-1954
- NPI assigned
- Oct 10, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801099162 | MI | Primary |
Addresses
Primary practice location
625 Harrison St
Kalamazoo, MI 49007-3681
Mailing address
625 Harrison St
Kalamazoo, MI 49007-3681
Phone (269) 323-1954
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6801099162 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1381363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459382400000",
"number": "1972930808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 HARRISON ST",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490073681",
"telephone_number": "269-323-1954",
"fax_number": "269-276-0201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 HARRISON ST",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490073681",
"telephone_number": "269-323-1954",
"fax_number": "269-323-1954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "SHIRLEY",
"middle_name": "L.",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-10-10",
"last_updated": "2016-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801099162",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.