Cheryl N Moffatt, LCPC

Individual provider Active NPI Professional Counselor · Riva, MD

NPI 1871831776 · NPPES record last updated Nov 20, 2015

Key facts

NPI
1871831776
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
LC6053 (MD)
Practice address
350 Derbyshire Lane
Riva, MD 21140
Phone
(410) 562-0327
NPI assigned
Jan 28, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LC6053MDMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC6053 MD Yes

Addresses

Primary practice location

350 Derbyshire Lane
Riva, MD 21140

Mailing address

350 Derbyshire LN
Riva, MD 21140-1511
Phone (410) 562-0327

Other providers in Riva, MD

All providers in Riva, MD · Professional Counselor in Maryland

Sources for this page

Verify at the official NPI Registry.