Individual
DENISE MOYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1040 WALTHAM ST, LEXINGTON, MA 02421-8033
(781) 761-5165
Mailing address
45 AUBURN ST, FRAMINGHAM, MA 01701-4849
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
215113
MA
103K00000X
Behavior Analyst
1-12-11628
MA
1041C0700X
Clinical Social Worker
215113
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000023532
BMC
MA
01
—
042611055
TAX ID
MA
01
—
1004745
NHP
MA
01
—
1303287
MBHP
MA
05
—
1303287
—
MA
01
—
99618201
NETWORKHEALTH
MA
01
—
M18633
BCBS
MA
Enumeration date
03/02/2009
Last updated
12/09/2016
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