MEDICARE: BIANCA ANGELICA MOCHA LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	19772	AZ
2	101YA0400X	Addiction (Substance Use Disorder) Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083026603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BIANCA ANGELICA MOCHA LPC

Provider Business Mailing Address
First Line	:	PO BOX 417147
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02241-7147
Country	:	US
Telephone Number	:	518-952-8140
Fax Number	:	518-952-8287

Provider Business Practice Location Address
First Line	:	2550 W UNION HILLS DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85027-5163
Country	:	US
Telephone Number	:	323-205-7088
Fax Number	:	833-419-0181

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2014
Last Update Date	:	10/31/2025

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