MEDICARE: MOXIE INCORPORATED

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	103TC0700X	Clinical Psychologist
2	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1972652725
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOXIE INCORPORATED

Provider Business Mailing Address
First Line	:	3001 SOUTH HENNEPIN AVENUE
Second Line	:	B301
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-2688
Country	:	US
Telephone Number	:	612-825-3440
Fax Number	:	612-827-2477

Provider Business Practice Location Address
First Line	:	3001 HENNEPIN AVE
Second Line	:	B301
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-2647
Country	:	US
Telephone Number	:	612-825-3440
Fax Number	:	612-827-2477

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. KELLY L BORSCH
Credential	:
Telephone Number	:	612-825-3440

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	09/11/2025

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Directions to “MOXIE INCORPORATED ” Practice Location

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