Olga V Moffett, CIDDT
Individual provider Active NPI Counselor · Wheatland, WY
NPI 1629200340 · NPPES record last updated Sep 8, 2026
Key facts
- NPI
- 1629200340
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 94443 (MS)
- Practice address
- 688 Antelope Gap Rd
Wheatland, WY 82201-8810 - Phone
- (307) 331-7869
- Fax
- (307) 316-0378
- NPI assigned
- Aug 13, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 94443 | MS | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 94443 | MS | Yes |
| Mental Health Counselor | 101YM0800X | BBH-LCPC-LIC-81088 | MT |
Addresses
Primary practice location
688 Antelope Gap Rd
Wheatland, WY 82201-8810
Mailing address
14 Plantation Dr
Hattiesburg, MS 39402-6116
Phone (601) 705-1901
Other practice location 1
14 Plantation Dr
Hattiesburg, MS 39402-6116
Phone (601) 705-1901
Other providers in Wheatland, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.