Provider Demographics
NPI:1871066936
Name:MOYER, MELINDA J (LSW)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:J
Last Name:MOYER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 DIAMOND ST
Mailing Address - Street 2:
Mailing Address - City:SELLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18960-2904
Mailing Address - Country:US
Mailing Address - Phone:267-218-2514
Mailing Address - Fax:
Practice Address - Street 1:420 COWPATH RD
Practice Address - Street 2:
Practice Address - City:SOUDERTON
Practice Address - State:PA
Practice Address - Zip Code:18964-2036
Practice Address - Country:US
Practice Address - Phone:267-203-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-10
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA134028104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker