Healthcare Provider Details

I. General information

NPI: 1871433946
Provider Name (Legal Business Name): SAMUEL CHERELL MOYER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 LAMBSON LN STE B102
NEW CASTLE DE
19720-2118
US

IV. Provider business mailing address

3256 CHAMPIONS DR
WILMINGTON DE
19808-2600
US

V. Phone/Fax

Practice location:
  • Phone: 302-510-6706
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: