MEDICARE: KARI VIOLET MOYER LCPC

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	180.017183	IL

General Provider Information

NPI Number	:	1831048453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARI VIOLET MOYER LCPC

Provider Business Mailing Address
First Line	:	2352 W SHAKESPEARE AVE UNIT 4A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-6464
Country	:	US
Telephone Number	:	267-373-8725
Fax Number	:

Provider Business Practice Location Address
First Line	:	2352 W SHAKESPEARE AVE UNIT 4A
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-6464
Country	:	US
Telephone Number	:	267-373-8725
Fax Number	:

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

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	01/26/2026

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