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NPI Code Detail

MEDICARE: MORIAH COCKERHAM LCMHCA

MEDICARE: MORIAH COCKERHAM LCMHCA
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
1101YP2500XProfessional CounselorA18540NC

General Provider Information

NPI Number : 1568167948
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORIAH COCKERHAM LCMHCA
Provider Business Mailing Address
First Line : 10700 SIKES PL STE 325
Second Line :
City : CHARLOTTE
State : NC
Zip : 28277-8208
Country : US
Telephone Number : 704-247-7353
Fax Number : 704-912-1614
Provider Business Practice Location Address
First Line : 10700 SIKES PL STE 325
Second Line :
City : CHARLOTTE
State : NC
Zip : 28277-8208
Country : US
Telephone Number : 704-247-7353
Fax Number : 704-912-1614
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2023
Last Update Date : 04/04/2023

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