Individual
MRS. SYREETA S MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
13603 KINGS ISLE CT, BOWIE, MD 20721-4237
(202) 907-2690
Mailing address
13603 KINGS ISLE CT, BOWIE, MD 20721-4237
(202) 907-2690
(301) 560-5290
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LC15305
MD
101Y00000X
Counselor
PC019996
PA
101YM0800X
Mental Health Counselor
Primary
LC15305
MD
101YM0800X
Mental Health Counselor
PC019996
PA
101YP2500X
Professional Counselor
LC15305
MD
101YP2500X
Professional Counselor
PC019996
PA
Other
Enumeration date
11/10/2022
Last updated
03/03/2026
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