Provider Demographics
NPI:1134265101
Name:MOODY, JAMES H (LMHC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:H
Last Name:MOODY
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 72705
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02907-0705
Mailing Address - Country:US
Mailing Address - Phone:401-273-6055
Mailing Address - Fax:401-739-6056
Practice Address - Street 1:2893 POST RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-3117
Practice Address - Country:US
Practice Address - Phone:401-273-6055
Practice Address - Fax:401-739-6056
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2025-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC000021101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health