MS. PHYLLIS M. MOODY (NPI# 1114291747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114291747 |
| Entity Type | Individual |
| Full Name | MS. PHYLLIS M. MOODY |
| Credential | LCAS-P |
| Practice Address |
104 New Stateside Dr Chapel Hill NC 27516-1165 |
| Practice Telephone | 9199422803 |
| Practice Fax Number | 9199422126 |
| Mailing Telephone | 9199422803 |
| Mailing Fax Number | 9199422126 |
| Enumeration Date | 2012-02-29 |
| Last Update Date | 2012-03-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
104 NEW STATESIDE DR |
| City | CHAPEL HILL |
| State | NC |
| Zip Code | 27516-1165 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568534485 | Barry C Weed | Psychiatry & Neurology | 104 New Stateside Dr, Chapel Hill, NC 27516-1165 | 2006-11-15 |
| 1861007528 | Molly Sweetser | Social Worker | 104 New Stateside Dr, Chapel Hill, NC 27516-1165 | 2020-09-10 |
| 1083255046 | Jordan Nicole Hyler | Counselor | 104 New Stateside Dr, Chapel Hill, NC 27516-1165 | 2019-10-01 |
| 1497210082 | Timeka Eileen Harper-purcell | Social Worker | 104 New Stateside Dr, Chapel Hill, NC 27516-1165 | 2019-02-07 |
| 1043781305 | Detra Renee Turner Baker | Counselor | 104 New Stateside Dr, Chapel Hill, NC 27516-1165 | 2018-12-16 |
| 1336610146 | Jesse R Mills Jr. | Licensed Practical Nurse | 104 New Stateside Dr, Chapel Hill, NC 27516-1165 | 2018-12-06 |
| 1609342336 | Maxine Foster Schroeder | Social Worker | 104 New Stateside Dr, Chapel Hill, NC 27516-1165 | 2018-10-20 |
| 1831630581 | Angela Davis | Nurse's Aide | 104 New Stateside Dr, Chapel Hill, NC 27516-1165 | 2017-03-14 |
| 1023469160 | Latisha Hendricks Teachey | Counselor | 104 New Stateside Dr, Chapel Hill, NC 27516 | 2016-06-30 |
| 1013374859 | Aurellia Anderson | Counselor | 104 New Stateside Dr, Chapel Hill, NC 27516-1165 | 2016-01-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417599309 | Brandon Ali Koroni | Dentist | 385 S Columbia St., Chapel Hill, NC 27516 | 2019-10-11 |
| 1225512718 | Brian Pietrosimone | Specialist/Technologist | University of North Carolina 209 Fetzer Hall, Chapel Hill, NC 27516 | 2018-09-20 |
| 1639691553 | Alexander S. Arab, Dba, Ims Evals, LLC | Physical Therapist | 103 Springhill Forest Place, Chapel Hill, NC 27516 | 2017-07-12 |
| 1730618000 | William E Sanders | Physical Therapist | 205 Weyer Dr., Chapel Hill, NC 27516 | 2017-06-08 |
| 1700336955 | Chatham Pediatric Dentistry | Dentist | 79 Falling Springs Dr., Suite 120, Chapel Hill, NC 27516 | 2016-10-12 |
| 1295152601 | Chun Xiang Li | Nurse Practitioner | 128 North Fields Circle, Chapel Hill, NC 27516 | 2014-03-24 |
| 1518211705 | Abigail Debra Zeveloff | Counselor | 1209b Hillsborough Rd, Chapel Hill, NC 27516 | 2012-11-09 |
| 1124315411 | Eric James Arehart | Pediatrics | 103 Crofton Springs Pl, Chapel Hill, NC 27516 | 2011-07-07 |
| 1336440312 | Amy Lynn Ford | Physician Assistant | 101 Manning Drive Cb #7160, Chapel Hill, NC 27516 | 2010-11-08 |
| 1689807224 | Natasha Leigh Blazer | Counselor | 110 New Stateside Dr, Chapel Hill, NC 27516 | 2009-08-31 |
| Find all providers in zip 27516 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548881907 | Synergy Care and Counseling Pllc | Counselor | 180 Providence Rd Ste 2, Chapel Hill, NC 27514-2206 | 2020-04-27 |
| 1538792817 | Allison Marie Schad | Counselor | 47 Hawk Point Rd, Chapel Hill, NC 27516-9851 | 2020-02-14 |
| 1760978175 | Kayla Chatterton Klemp | Counselor | 264 Medical School Wing D, Chapel Hill, NC 27599-0001 | 2018-07-09 |
| 1548668692 | Rex Mercer | Counselor | 406 New Parkside Dr, Chapel Hill, NC 27516-1163 | 2014-12-05 |
| 1326465337 | Kevin L Weber | Counselor | 1829 E Franklin St Ste 1200c, Chapel Hill, NC 27514-5804 | 2014-03-27 |
| 1356788038 | Katherine Lynn Cooper | Counselor | Infectious Diseases Clinic, Cb#7030; 101 Manning Drive, Chapel Hill, NC 27599-0001 | 2013-06-04 |
| 1518211705 | Abigail Debra Zeveloff | Counselor | 1209b Hillsborough Rd, Chapel Hill, NC 27516 | 2012-11-09 |
| 1902135049 | Michael Harry Santrizos | Counselor | 110 New Stateside Drive, Chapel Hill, NC 27516-1165 | 2009-12-21 |
| 1912233958 | Clayvon Everett | Counselor | 116 New Stateside Drive, Chapel Hill, NC 27516-1165 | 2009-10-27 |
| 1689807224 | Natasha Leigh Blazer | Counselor | 110 New Stateside Dr, Chapel Hill, NC 27516 | 2009-08-31 |
| Find all providers in CHAPEL HILL | ||||
| City | CHAPEL HILL |
| Zip Code | 27516 |
Please comment or provide details below to improve the information on MS. PHYLLIS M. MOODY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.