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

Individual provider Mental Health Counselor · NPI 1689984916

Kelley B Moule, MSW, LMSW is a Clinical Social Worker in Jackson, Mississippi. Qualified in 2008, 18 years ago. Practices with Oak Street Health Physicians Group of Mississippi, LLC, a 16-clinician group, works from 6 locations and accepts Medicare assignment. Licensed in Mississippi and South Carolina.

Years since qualifying
18
Licensed in
MS, SC
In the registry since
2010
Specialties on file
2
What do these letters mean?
MSW — Master of Social Work
The graduate degree in social work.
LMSW — Licensed Master Social Worker
A master's-level social worker, usually practising under supervision.

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Practice location Address checks out

911 Ellis Ave
Jackson, MS 39209-6256
Phone: (601) 533-7016
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (5)

  • 3600 Bluecutt Rd Ste 202, Columbus, MS 39705-1397 — (205) 246-5690
  • 1200 N State St Ste 455, Jackson, MS 39202-2000 — (601) 957-7343
  • 4541 N State St, Jackson, MS 39206-5308 — (601) 533-7017
  • 1 Medical Plaza Dr Ste B, Vicksburg, MS 39180-5187 — (205) 246-5690
  • 301 Palmetto Park Blvd, Lexington, SC 29072-7872 — (803) 996-1500

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence C9980 (MS)
Mental Health Counselor Taxonomy 101YM0800X · Licence 9101 (SC)

Record details

NPI number1689984916
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSW , LMSW
Sole proprietorNo
NPI enumeratedOctober 20, 2010
Last updated in NPPESNovember 13, 2024
Certification dateNovember 13, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Oak Street Health Physicians Group Of Mississippi, Llc — 16 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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