MEDICARE: STEPHANIE MOIR LMHC

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	101YM0800X	Mental Health Counselor	MH12679	FL

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	:	1639430507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE MOIR LMHC

Provider Business Mailing Address
First Line	:	3312 W KENNEDY BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-2904
Country	:	US
Telephone Number	:	813-321-8280
Fax Number	:

Provider Business Practice Location Address
First Line	:	3312 W KENNEDY BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-2904
Country	:	US
Telephone Number	:	813-321-8280
Fax Number	:

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

Provider Enumeration Date	:	06/06/2012
Last Update Date	:	03/03/2025

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Directions to “ STEPHANIE MOIR LMHC” Practice Location

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