Healthcare Provider Details

I. General information

NPI: 1396609210
Provider Name (Legal Business Name): NADINE PEH MOYIM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8484 GEORGIA AVE
SILVER SPRING MD
20910-5604
US

IV. Provider business mailing address

9957 GOOD LUCK RD
LANHAM MD
20706-3271
US

V. Phone/Fax

Practice location:
  • Phone: 202-868-2362
  • Fax:
Mailing address:
  • Phone: 227-238-9077
  • Fax: 227-238-9077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: