Healthcare Provider Details

I. General information

NPI: 1487142691
Provider Name (Legal Business Name): CHELSEA RAE MOYER MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHELSEA RAE HALAMA

II. Dates (important events)

Enumeration Date: 04/24/2018
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40195 WINSAND DR. SUITE 4
PIGEON FALLS WI
54760
US

IV. Provider business mailing address

PO BOX 249
PIGEON FALLS WI
54760-0249
US

V. Phone/Fax

Practice location:
  • Phone: 301-202-4693
  • Fax:
Mailing address:
  • Phone: 301-202-4693
  • Fax: 888-295-0375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11175-125
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7159-226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: