Individual provider Active NPI

Shannon Kay Moyer, MA, LMFT

  • Marriage & Family Therapist
  • Lemoyne, PA
National Provider Identifier
1053486340
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MF001189 Issued in PA
Practice address
635 N 12TH St Ste 101
Lemoyne, PA 17043-1225
Phone
(717) 412-0245
Fax
(717) 510-6704
NPI assigned
Nov 21, 2006
Last updated
Feb 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MF001189 PA Primary

Addresses

Primary practice location

635 N 12TH St Ste 101
Lemoyne, PA 17043-1225

Mailing address

635 N 12TH St Ste 101
Lemoyne, PA 17043-1225
Phone (717) 412-0245

Other names 1

  • Ms. Shannon Kay Struck Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MF001189PAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
In Him Christian Wellness PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1053486340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 N 12TH ST STE 101",
            "city": "LEMOYNE",
            "state": "PA",
            "postal_code": "170431225",
            "telephone_number": "717-412-0245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 N 12TH ST STE 101",
            "city": "LEMOYNE",
            "state": "PA",
            "postal_code": "170431225",
            "telephone_number": "717-412-0245",
            "fax_number": "717-510-6704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYER",
        "first_name": "SHANNON",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "PA",
            "license": "MF001189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "STRUCK",
            "middle_name": "KAY",
            "prefix": "MS.",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lemoyne, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.