Provider Demographics
NPI:1215577515
Name:MOSCHBERGER, CONTEE BOTCHFORD (MSED, MS, LPC)
Entity type:Individual
Prefix:MRS
First Name:CONTEE
Middle Name:BOTCHFORD
Last Name:MOSCHBERGER
Suffix:
Gender:F
Credentials:MSED, MS, LPC
Other - Prefix:MS
Other - First Name:HERON
Other - Middle Name:CONTEE
Other - Last Name:BOTCHFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:65 S MAIN ST STE C101
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-2847
Mailing Address - Country:US
Mailing Address - Phone:609-337-1352
Mailing Address - Fax:
Practice Address - Street 1:65 S MAIN ST STE C101
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-2847
Practice Address - Country:US
Practice Address - Phone:609-337-1352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-14
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010603101YP2500X
NJ37PC00702500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional