Provider Demographics
NPI:1811603228
Name:SINCLAIR, MOYA A (MHC-LP)
Entity type:Individual
Prefix:
First Name:MOYA
Middle Name:A
Last Name:SINCLAIR
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 FLORADALE RD
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-5621
Mailing Address - Country:US
Mailing Address - Phone:315-414-9167
Mailing Address - Fax:
Practice Address - Street 1:115 FLORADALE RD
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-5621
Practice Address - Country:US
Practice Address - Phone:315-414-9167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP120260101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health