Provider Demographics
NPI:1407245905
Name:MOELLER-MOON, JOANNE ELIZABETH (LPC)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:ELIZABETH
Last Name:MOELLER-MOON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 S STATE ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1956
Mailing Address - Country:US
Mailing Address - Phone:215-968-5151
Mailing Address - Fax:215-968-5222
Practice Address - Street 1:127 S STATE ST
Practice Address - Street 2:SUITE 7
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1956
Practice Address - Country:US
Practice Address - Phone:215-968-5151
Practice Address - Fax:215-968-5222
Is Sole Proprietor?:No
Enumeration Date:2015-01-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007089101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional