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General NPI Number Information
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NPI Number | 1558815449
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Entity Type | Individual
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Provider Name | ERIKA MOE LCPC
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Gender | Female
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Dates
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Enumeration Date | 08/08/2016
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 2498 N STOKESBERRY PL STE 170
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City | MERIDIAN
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State | ID
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Zip | 83646-5842
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Country | US
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Telephone | 208-901-1895
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 273
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City | STAR
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State | ID
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Zip | 83669-0273
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Country | US
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Telephone | 208-901-1895
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LCPC-7140
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License Number State | ID
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