Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Derrick Robert Moody

Individual provider Professional Counselor · NPI 1134931611

Derrick Robert Moody is a Professional Counselor in Kalispell, Montana. Practices as a sole proprietor. Licensed in Montana.

Licensed in
MT
In the registry since
2025

Practice location Address checks out

153 Wedgewood Ln
Kalispell, MT 59901-2643
Phone: (406) 290-9194
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence BBH-LCPC-LIC-77250 (MT)

Record details

NPI number1134931611
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 22, 2025
Last updated in NPPESNovember 10, 2025
Certification dateNovember 10, 2025
Mailing address9705 Lost Prairie Rd, Marion, MT 59925-9844

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