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General NPI Number Information
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NPI Number | 1265913974
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Entity Type | Individual
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Provider Name | ANGELA LARA MOENY MS, NCC, LCPC
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Gender | Female
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Dates
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Enumeration Date | 08/22/2018
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Last Update Date | 09/23/2020
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Provider Practice Location Address
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Address Line | 10410 KENSINGTON PKWY STE 225
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City | KENSINGTON
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State | MD
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Zip | 20895-2949
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Country | US
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Telephone | 240-424-5877
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Fax |
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Provider Business Mailing Address
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Address Line | 4003 PLYERS MILL RD
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City | KENSINGTON
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State | MD
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Zip | 20895-2019
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Country | US
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Telephone | 541-952-2264
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LGP8799
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LGP8799
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LGP8799
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License Number State | MD
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