Moeller, Fred T
Moeller, Fred T is an sole proprietor health care provider with primary practice located at 11805 Northfall Lane Suite 804, Alpharetta GA 30009. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Moeller, Fred T can be contacted via phone (770) 410-5788.Contact Information
Primary practice address
11805 Northfall Lane Suite 804
Alpharetta GA 30009
Phone: (770) 410-5788
Fax: (770) 410-4041
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 2084 | Georgia |
Profile Details
| NPI number | 1528190592 |
|---|---|
| LBN Legal business name | Moeller, Fred T |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 12th, 2007 |
| Last updated | Sep 23rd, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528190592 | NPPES |
| Georgia | Other | 241087000 | MAGELLAN BEHAVIORAL HEALT |
| Georgia | MEDICAID | 324771962A | MAGELLAN BEHAVIORAL HEALT |
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