Mrs Lisa Renee Moore, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Charleston, Mississippi. She graduated from medical school in 2014 and has 11 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Mdb Behavioral Health Services Llc and her current practice location is
3005 Teasdale Rd, Charleston, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(662) 809-0208.
Mrs Lisa Renee Moore is licensed to practice in Mississippi (license number C2276) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1922778935.
Healthcare Provider's Profile
Full Name | Mrs Lisa Renee Moore |
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Gender | Female |
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Speciality | Clinical Social Worker |
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Experience | 11 Years |
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Location | 3005 Teasdale Rd, Charleston, Mississippi |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Mrs Lisa Renee Moore graduated from medical school in 2014
NPI Data:
- NPI Number: 1922778935
- Provider Enumeration Date: 09/20/2021
- Last Update Date: 09/20/2021
Medicare PECOS Information:
- PECOS PAC ID: 2264829001
- Enrollment ID: I20220427000258
Medical Identifiers
Medical identifiers for Mrs Lisa Renee Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1922778935 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | C2276 (Mississippi) | Primary |
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Mdb Behavioral Health Services Llc | 0749572915 | 59 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Lisa Renee Moore allows following entities to bill medicare on her behalf.
Entity Name | Magnolia Counseling Clinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1952940454 PECOS PAC ID: 5496176109 Enrollment ID: O20200605000063 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Lisa Renee Moore is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Lisa Renee Moore, LCSW 3005 Teasdale Rd, Charleston, MS 38921-9576 Ph: (662) 809-0208 | Mrs Lisa Renee Moore, LCSW 3005 Teasdale Rd, Charleston, MS 38921-9576 Ph: (662) 809-0208 |
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