Charity Shaw-moyado, Llc | |
200 W. Fifth Ave. Suite 118 Naperville IL 60563 | |
(773) 270-3522 | |
Not Available |
Full Name | Charity Shaw-moyado, Llc |
---|---|
Speciality | Counselor |
Location | 200 W. Fifth Ave., Naperville, Illinois |
Authorized Official Name and Position | Charity Shaw-moyado (OWNER) |
Authorized Official Contact | 7732703522 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Charity Shaw-moyado, Llc 76 Bunting Ln Naperville IL 60565-1333 Ph: () - | Charity Shaw-moyado, Llc 200 W. Fifth Ave. Suite 118 Naperville IL 60563 Ph: (773) 270-3522 |
NPI Number | 1962160390 |
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Provider Enumeration Date | 12/02/2021 |
Last Update Date | 12/15/2021 |
Certification Date | 12/15/2021 |
Medicare PECOS PAC ID | 3678954930 |
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Medicare Enrollment ID | O20220718001802 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962160390 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Charity Shaw Moyado |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1396825196 PECOS PAC ID: 8224077623 Enrollment ID: I20050426000583 |
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