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Individual
DR. MUSTAFA MOYENDA
Active
Individual
DR. MUSTAFA MOYENDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC, CAADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
14823
IL
101YP2500X
Professional Counselor
Primary
180003124
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180003124
LCPC LICENSE
IL
Enumeration date
09/03/2008
Last updated
10/19/2018
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