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NPI Code Detail

MEDICARE: TALISHA CARTER-MOODY LPC

MEDICARE: TALISHA CARTER-MOODY 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
1101YM0800XMental Health CounselorLPC0009461GA

General Provider Information

NPI Number : 1770052474
Entity Type Code : Individual
Provider Name (Legal Business Name) : TALISHA CARTER-MOODY LPC
Provider Business Mailing Address
First Line : 105 COLLEGE CT
Second Line :
City : FORT VALLEY
State : GA
Zip : 31030-4402
Country : US
Telephone Number : 478-721-7095
Fax Number :
Provider Business Practice Location Address
First Line : 402 OSIGIAN BLVD STE 400
Second Line :
City : WARNER ROBINS
State : GA
Zip : 31088-8992
Country : US
Telephone Number : 478-333-3058
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2018
Last Update Date : 03/03/2026

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Directions to “ TALISHA CARTER-MOODY LPC” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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