Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Kenneth Jerald Moore, PHDLCSW

Individual provider Clinical Social Worker · NPI 1376722348

Dr. Kenneth Jerald Moore, PHDLCSW is a Clinical Social Worker in Tulsa, Oklahoma. Practices as a sole proprietor. Licensed in Oklahoma.

Licensed in
OK
In the registry since
2007

Practice location Address checks out

6906 S Utica Pl
Tulsa, OK 74136-5158
Phone: (918) 794-4596
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 2165 (OK)

Record details

NPI number1376722348
Entity typeIndividual (Type 1)
GenderMale
Credentials PHDLCSW
Sole proprietorYes
NPI enumeratedOctober 26, 2007
Last updated in NPPESAugust 14, 2009

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