Spencer Moore, LCSW
Social Worker, Clinical in Las Vegas, NV. Individual provider (NPI-1).
NPI number1689350753
StatusActive
Last updated in NPPESNov 6, 2026
Details
- NPI
- 1689350753
- Entity type
- Individual (NPI-1)
- Name
- Mr. Spencer Moore
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 23, 2023
- Certification date
- Nov 6, 2026
- Last updated
- Nov 6, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CLINICAL SOCIAL WORKER
- Can order and refer
- Part B Yes · DME Yes · Home health No · Power mobility No · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 13104-C | NV | Yes |
Practice location
10609 Lessona StLas Vegas, NV 89141-0473
Phone 702-381-1854
Mailing address
10609 Lessona StLas Vegas, NV 89141-0473
Phone 951-323-4093
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