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General NPI Number Information
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NPI Number | 1962987768
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Entity Type | Individual
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Provider Name | JOHN DAVID MOJZISEK PHD, LCPC
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Gender | Male
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Dates
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Enumeration Date | 09/27/2018
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Last Update Date | 09/27/2018
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Provider Practice Location Address
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Address Line | 1447 YORK RD STE 701
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City | LUTHERVILLE
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State | MD
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Zip | 21093-6017
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Country | US
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Telephone | 443-904-2066
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Fax |
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Provider Business Mailing Address
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Address Line | 7907 WESTMORELAND AVE
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City | PARKVILLE
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State | MD
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Zip | 21234-5421
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Country | US
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Telephone | 443-904-2066
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC1416
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License Number State | MD
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