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

Marissa Moore, LCSW

Individual provider Clinical Social Worker · NPI 1306530159

Marissa Moore, LCSW is a Clinical Social Worker in Louisville, Kentucky. Qualified in 2023, 3 years ago. Works from 2 locations. Licensed in Kentucky.

Years since qualifying
3
Licensed in
KY
In the registry since
2023
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

9700 Park Plaza Ave Unit 210
Louisville, KY 40241-2287
Phone: (502) 785-4322
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 527 N Joe B Hall Ave, Shepherdsville, KY 40165 — (502) 589-8600

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCSW00001076 (KY)

Record details

NPI number1306530159
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedJune 5, 2023
Last updated in NPPESMay 13, 2026
Certification dateMay 13, 2026

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations4 on file with Medicare

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