ANDREA MOSS LCSW
NPI 1174191241
Social Worker in Champaign, IL

Q: What is Andrea Moss's NPI number?

The NPI number for Andrea Moss is 1174191241. It was assigned to this individual provider in the NPPES registry on June 15, 2021.

Q: What is Andrea Moss's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Q: When was this NPI record last updated?

The NPPES record for Andrea Moss was last updated on June 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 15, 2021PECOS EnrolledAccepts Medicare Assignment

1802 S MATTIS AVE, CHAMPAIGN, IL 61821(217) 383-1850(217) 383-3439 Get Directions Write a Review

NPPES record last updated: June 15, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Andrea Moss Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANDREA MOSS LCSW (NPI 1174191241) is an individual social worker in Champaign, Illinois, licensed in Illinois (149012800) and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2004).

NPPES Registry Identity

NPI1174191241

Entity TypeIndividualFemale

Primary Taxonomy104100000X

Provider Legal NameANDREA MOSSCredential: LCSW

Location Address1802 S MATTIS AVEChampaign, IL 61821-5923

Mailing Address611 W Park St, FapcUrbana, IL 61801

Phone(217) 383-1850

Fax(217) 383-3439

Sole ProprietorNo

Medical School CMSOtherGraduated 2004

Enumeration DateJune 15, 2021

NPPES CertifiedJune 1, 2021

✔ NPI 1174191241 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers

Taxonomy Code104100000X

License✔ Licensed in IL · 149012800

Definition

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

1802 S MATTIS AVE, Champaign, IL 61821

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Andrea Moss Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6608277520

PECOS Enrollment IDI20210630000532

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RACHAEL D RUBIN PHD

Psychologist