MISS SHANNON LEIGH MOORE (LCSW) – Clinical Social Worker, NPI 1366747842

MISS SHANNON LEIGH MOORE (LCSW) is a healthcare provider. based in Jonesboro, Arkansas. specializing in Clinical Social Worker. They hold the professional credentials LCSW. They hold a License No. 7953-C (AR). The NPI Number for MISS SHANNON LEIGH MOORE (LCSW) is 1366747842

Main info

Female
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
MISS SHANNON LEIGH MOORE (LCSW)
NPI
1366747842
Phone
(870) 277-4357
Address
800 S CHURCH ST STE 103
Enumeration Date
14 January 2011
Last Update Date
18 February 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8702774357
Graduation Year
2016 (10 years ago)
PAC ID
8325385164
Group Practice PAC ID
1759703010
Professional Enrollment ID
I20190131002832
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:15State licenses:1Digital endpointsOther names

Provider Addresses for MISS SHANNON LEIGH MOORE (LCSW)

  • 800 S CHURCH ST STE 103

    JONESBORO, AR 724014154

    Phone: (870) 277-4357

    Fax: (870) 292-3603

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-01-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190131002832IClinical Social WorkerARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour15316$0
View full utilization report →

Insurance plans in this area (ZIP 72401)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1759703010View full group profile
NameSpecialtyState
Geriatric PsychiatryAR
Mental Health CounselorAR
Mental Health CounselorAR
-AR
-AR

Reviews

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Frequently asked questions

How do payers reference MISS SHANNON LEIGH MOORE (LCSW)?
For MISS SHANNON LEIGH MOORE (LCSW), use NPI 1366747842 as the unique 10-digit identifier.
Is there an active status for MISS SHANNON LEIGH MOORE (LCSW)?
For scheduling context, MISS SHANNON LEIGH MOORE (LCSW) is shown as active in the registry.
What clinical focus is listed for MISS SHANNON LEIGH MOORE (LCSW)?
At a glance, MISS SHANNON LEIGH MOORE (LCSW) is tied to Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What locale is associated with MISS SHANNON LEIGH MOORE (LCSW)?
Directory geography for MISS SHANNON LEIGH MOORE (LCSW) centers on Jonesboro, Arkansas.
Can I trust this NPI listing for MISS SHANNON LEIGH MOORE (LCSW)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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