MEDICARE: MRS. ANNMAY MICHELLE MORANT 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	101YM0800X	Mental Health Counselor	0701005300	VA

General Provider Information

NPI Number	:	1760733257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANNMAY MICHELLE MORANT LPC

Provider Business Mailing Address
First Line	:	8424 SHELDON BRANCH PL
Second Line	:
City	:	TOANO
State	:	VA
Zip	:	23168-9266
Country	:	US
Telephone Number	:	757-202-7681
Fax Number	:

Provider Business Practice Location Address
First Line	:	474 COLONIAL TRAIL WEST
Second Line	:
City	:	SURRY
State	:	VA
Zip	:	23883-0296
Country	:	US
Telephone Number	:	757-294-0037
Fax Number	:	757-294-5113

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

Provider Enumeration Date	:	09/25/2012
Last Update Date	:	09/25/2012

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