Provider Demographics
NPI:1316228877
Name:MOYO, SIKHUMBUZO 'KIM' (LCSW)
Entity Type:Individual
Prefix:
First Name:SIKHUMBUZO 'KIM'
Middle Name:
Last Name:MOYO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3933 N CLARENDON AVE APT 109
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-3201
Mailing Address - Country:US
Mailing Address - Phone:312-701-4376
Mailing Address - Fax:
Practice Address - Street 1:3933 N CLARENDON AVE APT 109
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-3201
Practice Address - Country:US
Practice Address - Phone:312-701-4376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-29
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR101YM0800XOtherCASCADIA BEHAVIORAL HEALTH