Provider Demographics
NPI:1598130866
Name:MOODY, ARIKA LYNNETTE (MA, LMFT)
Entity Type:Individual
Prefix:MISS
First Name:ARIKA
Middle Name:LYNNETTE
Last Name:MOODY
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 OLD YORK RD APT A115
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19126-2238
Mailing Address - Country:US
Mailing Address - Phone:267-467-4806
Mailing Address - Fax:
Practice Address - Street 1:6901 OLD YORK RD APT A115
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19126-2238
Practice Address - Country:US
Practice Address - Phone:267-467-4806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-11
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
PAMF001111106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor