Provider Demographics
NPI:1811427800
Name:HOZHO BEHAVIORAL HEALTH AND LIFE COACHING SERVICES, PLLC
Entity type:Organization
Organization Name:HOZHO BEHAVIORAL HEALTH AND LIFE COACHING SERVICES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE CATHERINE
Authorized Official - Middle Name:CORBIN
Authorized Official - Last Name:MOYA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:856-912-0314
Mailing Address - Street 1:13006 DUBIN DR
Mailing Address - Street 2:
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22551-8012
Mailing Address - Country:US
Mailing Address - Phone:856-912-0314
Mailing Address - Fax:
Practice Address - Street 1:11903 MAIN ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-7326
Practice Address - Country:US
Practice Address - Phone:540-684-8962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-13
Last Update Date:2020-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040096331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA581935Medicaid