Provider Demographics
NPI:1982377404
Name:MOXIE COUNSELING SERVICES
Entity Type:Organization
Organization Name:MOXIE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BABB
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-920-3451
Mailing Address - Street 1:1320 WALTON BLUFF TER
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-3175
Mailing Address - Country:US
Mailing Address - Phone:804-372-7298
Mailing Address - Fax:
Practice Address - Street 1:1320 WALTON BLUFF TER
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-3175
Practice Address - Country:US
Practice Address - Phone:804-372-7298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-29
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
1497331896OtherNPI 1