Provider Demographics
NPI:1780343244
Name:MOY, LAI T (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:LAI
Middle Name:T
Last Name:MOY
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 S 18TH ST APT 3F
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-5238
Mailing Address - Country:US
Mailing Address - Phone:201-725-7947
Mailing Address - Fax:
Practice Address - Street 1:1315 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5601
Practice Address - Country:US
Practice Address - Phone:215-259-8491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-13
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health