| Moxie Professional Counseling Llc | |
|
333 State St Ste B Newburgh IN 47630-1270 | |
| (812) 777-5230 | |
| (812) 315-0222 |
| Full Name | Moxie Professional Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 333 State St Ste B, Newburgh, Indiana |
| Authorized Official Name and Position | Nichole Devonshire (OWNER) |
| Authorized Official Contact | 8124995004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Moxie Professional Counseling Llc Po Box 784 Newburgh IN 47629-0784 Ph: (812) 777-5230 | Moxie Professional Counseling Llc 333 State St Ste B Newburgh IN 47630-1270 Ph: (812) 777-5230 |
| NPI Number | 1144701996 |
|---|---|
| Provider Enumeration Date | 08/28/2018 |
| Last Update Date | 08/18/2022 |
| Certification Date | 08/18/2022 |
| Medicare PECOS PAC ID | 3072866284 |
|---|---|
| Medicare Enrollment ID | O20181105001143 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144701996 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lora K Gray |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043218647 PECOS PAC ID: 8022047281 Enrollment ID: I20050808000823 |
| Provider Name | Kari A Hulfachor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487709929 PECOS PAC ID: 3274619481 Enrollment ID: I20080328000329 |
| Provider Name | Julia K Tredway |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558416024 PECOS PAC ID: 8325104854 Enrollment ID: I20090306000355 |
| Provider Name | Nichole Fe Devonshire |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457832438 PECOS PAC ID: 2860745072 Enrollment ID: I20181107000748 |
| Provider Name | Lisa Cossey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457921199 PECOS PAC ID: 5597162396 Enrollment ID: I20210921003197 |
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