Speller, Keisha Moore
Speller, Keisha Moore is an sole proprietor health care provider with primary practice located at 216 Stewart Pkwy , Washington NC 27889. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Speller, Keisha Moore can be contacted via phone (252) 946-0585.Contact Information
Primary practice address
216 Stewart Pkwy
Washington NC 27889
Phone: (252) 946-0585
Fax: (252) 946-0580
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 3291 | North Carolina |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 10072 | North Carolina |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 10072 | North Carolina |
Profile Details
| NPI number | 1083955272 |
|---|---|
| LBN Legal business name | Speller, Keisha Moore |
| Credentials | Master of Arts (MA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 13th, 2013 |
| Last updated | Jun 28th, 2018 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083955272 | NPPES |
| North Carolina | Other | 10072 | LPC |
| North Carolina | MEDICAID | 10072 | LPC |
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