Active NPI
Allison Nicole Moberly, LCPC
- Professional Counselor
- Port Deposit, MD
National Provider Identifier
1457768855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC10645
- Practice address
- 202 N Main St Apt L
Port Deposit, MD 21904-1292 - Phone
- (315) 261-8202
- NPI assigned
- Jul 17, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LC10645 | MD | Primary |
Addresses
Primary practice location
202 N Main St Apt L
Port Deposit, MD 21904-1292
Mailing address
202 N Main St Apt L
Port Deposit, MD 21904-1292
Phone (315) 261-8202
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC10645 | MD | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606348800000",
"number": "1457768855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 N MAIN ST APT L",
"city": "PORT DEPOSIT",
"state": "MD",
"postal_code": "219041292",
"telephone_number": "315-261-8202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 N MAIN ST APT L",
"city": "PORT DEPOSIT",
"state": "MD",
"postal_code": "219041292",
"telephone_number": "315-261-8202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOBERLY",
"first_name": "ALLISON",
"middle_name": "NICOLE",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-17",
"last_updated": "2020-11-26",
"certification_date": "2020-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC10645",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Deposit, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.