Provider Demographics
NPI:1407621980
Name:MAGID, MOIRA (LPC, LMHC)
Entity Type:Individual
Prefix:
First Name:MOIRA
Middle Name:
Last Name:MAGID
Suffix:
Gender:F
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:MOIRA
Other - Middle Name:
Other - Last Name:ANTHONY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, LMHC
Mailing Address - Street 1:25 W SPLIT ROCK DR
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1339
Mailing Address - Country:US
Mailing Address - Phone:609-304-9650
Mailing Address - Fax:
Practice Address - Street 1:10000 MIDLANTIC DR STE 101E
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-1504
Practice Address - Country:US
Practice Address - Phone:609-304-9650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-15
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009973101YM0800X
NJ37PC00993700101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health