| Doctor Name: | DR. CARL STEPHEN MOISOFF |
| NPI Number: | 1083680987 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSYD |
| License Number: | 20040404A |
| Business Practice Address: | 8500 Broadway St Ste A Merrillville, IN - 46410 |
| Business Phone Number: | 8006487608 |
| Business Fax Number: | 2197369456 |
| Mailing Address: | 9910 Arthur Court, CROWN POINT |
| State: | IN |
| Postal Code: | 463072357 |
| Phone Number: | 2196620362 |
| Fax Number: | 2197369456 |
| NPI Enumeration Date: | 02/28/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 20040404A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |