Provider Demographics
NPI:1841901212
Name:COUNSELING WITH MOXIE PLLC
Entity type:Organization
Organization Name:COUNSELING WITH MOXIE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:KRISTYNE
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DSW, LCSW-S, LCDC
Authorized Official - Phone:512-601-0619
Mailing Address - Street 1:PO BOX 528
Mailing Address - Street 2:
Mailing Address - City:CEDAR CREEK
Mailing Address - State:TX
Mailing Address - Zip Code:78612-0528
Mailing Address - Country:US
Mailing Address - Phone:512-601-0619
Mailing Address - Fax:
Practice Address - Street 1:222 MCDONALD LN E
Practice Address - Street 2:
Practice Address - City:CEDAR CREEK
Practice Address - State:TX
Practice Address - Zip Code:78612-3161
Practice Address - Country:US
Practice Address - Phone:612-601-0619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty