Individual provider Active NPI

Leondra Alecia Moore, LCSW

  • Clinical Social Worker
  • Oklahoma City, OK
National Provider Identifier
1992004626
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1006 NE 17TH St
Oklahoma City, OK 73111-1002
Phone
(405) 419-9800
Fax
(405) 521-8496
NPI assigned
Mar 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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 OK Primary

Addresses

Primary practice location

1006 NE 17TH St
Oklahoma City, OK 73111-1002

Mailing address

PO Box 30589
Midwest City, OK 73140-3589
Phone (405) 769-3301

Other practice location 1

632 Thorn Briar Rd
Edmond, OK 73034-4276
Phone (405) 406-8771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20110628000557 OK Practitioner - Clinical Social Worker 4284812967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Southern Illinois University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Centers, Inc.Group PAC ID 4688584436, 10 clinicians

Practice addresses (Care Compare)

1006 NE 17TH St
Oklahoma City, OK 73111-1002
Phone (405) 769-3301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers Inc. CurrentSince Nov 16, 2024 Accepting new patients
Community Health Centers, Inc. CurrentSince Nov 16, 2024 Accepting new patients

Locations

5301 S Dimple Dr
Oklahoma City, OK 73135
Phone (405) 674-0028

12716 NE 36th St
Spencer, OK 73084
Phone (405) 466-2535

Organizations & group practices 8

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": "1300665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1992004626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30589",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731403589",
            "telephone_number": "405-769-3301",
            "fax_number": "405-769-9685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 NE 17TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731111002",
            "telephone_number": "405-419-9800",
            "fax_number": "405-521-8496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "632 Thorn Briar Rd",
            "address_purpose": "LOCATION",
            "city": "Edmond",
            "state": "OK",
            "postal_code": "730344276",
            "country_code": "US",
            "telephone_number": "405-406-8771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LEONDRA",
        "middle_name": "ALECIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-21",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.