MEDICARE: MR. JOHN EDWARD MOYER M. ED.

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	101YP2500X	Professional Counselor	PC002488	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PC002488	OTHER	PA	LPC

General Provider Information

NPI Number	:	1821287723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN EDWARD MOYER M. ED.

Provider Business Mailing Address
First Line	:	141 S HIGHLAND AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15206-3932
Country	:	US
Telephone Number	:	412-363-1702
Fax Number	:	412-363-3725

Provider Business Practice Location Address
First Line	:	141 S HIGHLAND AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15206-3932
Country	:	US
Telephone Number	:	412-363-1702
Fax Number	:	412-363-3725

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

Provider Enumeration Date	:	10/17/2007
Last Update Date	:	10/17/2007

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Directions to “ MR. JOHN EDWARD MOYER M. ED.” Practice Location

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