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NPI Code Detail

MEDICARE: RHONDA R CLARK-MOSES MS, LLPC

MEDICARE: RHONDA R CLARK-MOSES MS, LLPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor6401015756MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
16401015756OTHERMILLPC

General Provider Information

NPI Number : 1316398290
Entity Type Code : Individual
Provider Name (Legal Business Name) : RHONDA R CLARK-MOSES MS, LLPC
Provider Business Mailing Address
First Line : 3400 S WASHINGTON RD
Second Line :
City : SAGINAW
State : MI
Zip : 48601-4958
Country : US
Telephone Number : 989-755-1072
Fax Number : 989-755-1401
Provider Business Practice Location Address
First Line : 3400 S WASHINGTON RD
Second Line :
City : SAGINAW
State : MI
Zip : 48601-4958
Country : US
Telephone Number : 989-755-1072
Fax Number : 989-755-1401
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2016
Last Update Date : 05/07/2026

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