Kelly, Moise

Kelly, Moise is an sole proprietor health care provider with primary practice located at 455 S Mesa Dr Unit 142 , Mesa AZ 85210-2711. He recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Social Worker, Other Service Providers / Case Manager/Care Coordinator, Other Service Providers / Health Educator, Other Service Providers / Community Health Worker. Other Service Providers / Community Health Worker is his primary health care specialty. Kelly, Moise can be contacted via phone (480) 277-0313.

Contact Information

Primary practice address
455 S Mesa Dr Unit 142 Mesa AZ 85210-2711
Phone: (480) 277-0313
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 957399 Arizona
Behavioral Health & Social Service Providers / Social Worker 104100000X 957399 Arizona
Other Service Providers / Case Manager/Care Coordinator 171M00000X 957399 Arizona
Other Service Providers / Health Educator 174H00000X 957399 Arizona
Other Service Providers / Community Health Worker 172V00000X 957399 Arizona

Profile Details

NPI number 1447640958
LBN Legal business name Kelly, Moise
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 4th, 2015
Last updated Jul 16th, 2019 - about 7 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 1447640958 NPPES
Arizona MEDICAID 957399

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