Healthcare Provider Details

I. General information

NPI: 1679344287
Provider Name (Legal Business Name): MCCAY MARTIN MOIFORAY ED.D, LGPC, MPH, CHE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2024
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4445 WILLARD AVE STE 600
CHEVY CHASE MD
20815-3786
US

IV. Provider business mailing address

4445 WILLARD AVE STE 600
CHEVY CHASE MD
20815-3786
US

V. Phone/Fax

Practice location:
  • Phone: 443-379-7593
  • Fax:
Mailing address:
  • Phone: 443-379-7593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC16951
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: