Healthcare Provider Details

I. General information

NPI: 1093623910
Provider Name (Legal Business Name): YOON SUH MOH PH.D., LPC, BCN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1288 VALLEY FORGE RD
PHOENIXVILLE PA
19460-2687
US

IV. Provider business mailing address

321 CALEY CT
KING OF PRUSSIA PA
19406-1547
US

V. Phone/Fax

Practice location:
  • Phone: 631-213-1475
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC011650
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: