Healthcare Provider Details

I. General information

NPI: 1134940133
Provider Name (Legal Business Name): SIERRA NICOLE MOYE MS, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2024
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7855 ARGYLE FOREST BLVD STE 404
JACKSONVILLE FL
32244-7702
US

IV. Provider business mailing address

178 BERMUDA CT
PONTE VEDRA BEACH FL
32082-2503
US

V. Phone/Fax

Practice location:
  • Phone: 904-494-8273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number24252
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: