Moonstarr, Nancy Joan

Moonstarr, Nancy Joan is an sole proprietor health care provider with primary practice located at 4 Riverview Rd , Severna Park MD 21146-4630. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Moonstarr, Nancy Joan can be contacted via phone (410) 431-8870.

Contact Information

Primary practice address
4 Riverview Rd Severna Park MD 21146-4630
Fax: (410) 431-7177
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY1000166 District of Columbia
Behavioral Health & Social Service Providers / Professional 101YP2500X LC0408 Maryland

Profile Details

NPI number 1982779674
LBN Legal business name Moonstarr, Nancy Joan
Credentials PHD & LPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 21st, 2006
Last updated Dec 22nd, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982779674 NPPES
District of Columbia Other PSY1000166 PSYCHOLOGIST LICENSE
District of Columbia MEDICAID 188103500 PSYCHOLOGIST LICENSE
District of Columbia Other LC0408 PSYCHOLOGIST LICENSE

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