Healthcare Provider Details

I. General information

NPI: 1689594764
Provider Name (Legal Business Name): JANEICEA MOSLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5420 BUFORD HWY APT 2304
NORCROSS GA
30071-3994
US

IV. Provider business mailing address

5420 BUFORD HWY APT 2304
NORCROSS GA
30071-3994
US

V. Phone/Fax

Practice location:
  • Phone: 662-579-5011
  • Fax:
Mailing address:
  • Phone: 662-579-5011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: