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NPI Code Detail

MEDICARE: MR. DAVE MOORTHY LPC

MEDICARE: MR. DAVE MOORTHY LPC
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
1101YP2500XProfessional CounselorLPC008255GA
2101YA0400XAddiction (Substance Use Disorder) CounselorC0108GA

General Provider Information

NPI Number : 1376069294
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVE MOORTHY LPC
Provider Business Mailing Address
First Line : 4800 N SCOTTSDALE RD STE 2500
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-7630
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2055 SUGARLOAF CIR STE 575
Second Line :
City : DULUTH
State : GA
Zip : 30097-9804
Country : US
Telephone Number : 404-999-7971
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2017
Last Update Date : 03/12/2026

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Directions to “ MR. DAVE MOORTHY LPC” Practice Location

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