Kelley B Moule, MSW, LMSW

Clinical Social Worker · Jackson, MS

Call (601) 533-7016 Directions

At a glance

911 Ellis Ave, Jackson, MS 39209-6256

NPPES record updated Nov 13, 2024. Public records can lag behind changes at a practice.

Before you call: a quick checklist
  • Are you accepting new patients?
  • Do you accept my specific insurance plan?
  • Do you provide the service I need at this address?
  • Do I need a referral, and what is the earliest appointment?

Insurance participation and appointment availability are not established by these public records.

Medicare & insurance

Insurance participation is not established by these public records. Ask the practice and your insurer about your specific plan and this location.

How to check your coverage

Use your plan’s provider directory or the member-services number on your insurance card. Confirm the clinician, practice address, service, and whether a referral is required. A missing opt-out record does not establish Medicare acceptance.

Check the official Medicare directory ↗

Practice location

911 Ellis Ave
Jackson, MS 39209-6256

Additional reported practice locations

301 Palmetto Park Blvd
Lexington, SC 290727872
Phone: 8039961500
Fax: 8039961510
1 Medical Plaza Dr Ste B
Vicksburg, MS 391805187
Phone: 2052465690
3600 Bluecutt Rd Ste 202
Columbus, MS 397051397
Phone: 2052465690
1200 N State St Ste 455
Jackson, MS 392022000
Phone: 6019577343
4541 N State St
Jackson, MS 392065308
Phone: 6015337017
REPORTED BACKGROUND

Education & affiliations

Medical / professional school
Not reported in this file
Graduation year
2008
CMS specialties
Clinical Social Worker

Practice groups

Graduation year does not establish years in practice. A reported affiliation does not establish employment, current admitting privileges, or insurance participation.

Source: CMS National Downloadable File · Published Oct 15, 2026.

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PUBLISHED MEDICARE ACTIVITY

Procedures in the public data

Reported activity can help you ask more informed questions about a practice’s services.

No displayed procedure-category record in this release. This does not mean the clinician performs no procedures.

CMS uses a one-year claims window with a reporting lag. Counts cover the Medicare activity included by CMS, not all patients. “1–10” is a published range. Volume is not a quality or outcomes score. Coverage and methodology

Source: CMS Utilization Data · Published Oct 15, 2026.

Service-mix comparison is unavailable for this NPI in the imported Medicare service file.

PAYMENT TRANSPARENCY

Industry-reported general payments

No matching general-payment summary in the imported release. This is not a verified zero and does not rule out other payment types or years.

Source: CMS 2025 payments grouped by covered recipient and nature of payments · Published Jun 30, 2026.

Professional details: NPI, taxonomy & registry record
NPI1689984916
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Registry details

Primary taxonomy
Clinical Social Worker
Taxonomy code
1041C0700X
Enumeration date
Oct 20, 2010
Record updated
Nov 13, 2024
More registry details
Provider type
Individual · Type 1
Reported credentials
MSW, LMSW

Reported taxonomies and licenses

Mental Health Counselor

101YM0800X

License reported: 9101 SC

Clinical Social Worker

1041C0700X · Primary

License reported: C9980 MS

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

911 Ellis Ave
Jackson, MS 39209-6256
Phone
(601) 533-7016
Mailing address
PO BOX 746085

ATLANTA, GA 303746085
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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