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NPI Code Detail

MEDICARE: MR. MOSES SGUNRO

MEDICARE: MR. MOSES SGUNRO
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
1101Y00000XCounselorOK
2101YA0400XAddiction (Substance Use Disorder) CounselorOK
3101YM0800XMental Health CounselorOK
4101YP2500XProfessional CounselorOK
5106H00000XMarriage & Family TherapistOK

Other Identifiers

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

General Provider Information

NPI Number : 1619211349
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MOSES SGUNRO
Provider Business Mailing Address
First Line : 3517 RIDGLEA CT
Second Line :
City : DEL CITY
State : OK
Zip : 73115-1831
Country : US
Telephone Number : 405-672-8201
Fax Number :
Provider Business Practice Location Address
First Line : 3517 RIDGLEA CT
Second Line :
City : DEL CITY
State : OK
Zip : 73115-1831
Country : US
Telephone Number : 405-672-8201
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2012
Last Update Date : 12/05/2012

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