Individual provider Active NPI

Deja' Moses

  • Professional Counselor
  • Towson, MD
National Provider Identifier
1104410943
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC14848 Issued in MD
Practice address
22 W Pennsylvania Ave Ste 414
Towson, MD 21204-5003
Phone
(443) 281-9454
NPI assigned
Feb 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC14848 MD Primary

Addresses

Primary practice location

22 W Pennsylvania Ave Ste 414
Towson, MD 21204-5003

Mailing address

1341 Hill Born Dr
Hanover, MD 21076-1174
Phone (443) 942-2843

Other practice location 1

1341 Hill Born Dr
Hanover, MD 21076-1174
Phone (410) 774-5120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250101000108 MD Practitioner - Mental Health Counselor 6002343191 Reassigns benefits to 1 organization
I20260518002305 DC Practitioner - Mental Health Counselor 6002343191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1341 Hill Born Dr
Hanover, MD 21076-1174

14314 Old Marlboro Pike
Upper Marlboro, MD 20772-2840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Authentic Corner, LLC Mental Health CurrentSince Sep 29, 2024 Accepting new patients
Divine Counseling LLC CurrentSince Dec 23, 2024 Accepting new patients
Empathetic Connections LLC CurrentSince Apr 28, 2024 Accepting new patients
Divine Counseling LLC CurrentSince Dec 23, 2024 Accepting new patients
Deevoted Dreamz LLC Mental Health CurrentSince Jul 16, 2023 Accepting new patients

Locations

90 Painters Mill Rd
Ste 135136
Owings Mills, MD 21117
Phone (443) 955-2662

1829 Reisterstown Rd
Ste 350
Pikesville, MD 21208
Phone (443) 226-1676

22 W Pennsylvania Ave
Ste 414
Towson, MD 21204
Phone (443) 281-9454

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1104410943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 HILL BORN DR",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210761174",
            "telephone_number": "443-942-2843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 W PENNSYLVANIA AVE STE 414",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212045003",
            "telephone_number": "443-281-9454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1341 Hill Born Dr",
            "address_purpose": "LOCATION",
            "city": "Hanover",
            "state": "MD",
            "postal_code": "210761174",
            "country_code": "US",
            "telephone_number": "410-774-5120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSES",
        "first_name": "DEJA'",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-23",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC14848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.