Healthcare Provider Details

I. General information

NPI: 1194610048
Provider Name (Legal Business Name): SUZANNE MOSER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 SHAW AVE
MCKEESPORT PA
15132-2918
US

IV. Provider business mailing address

5340 WILDERNESS LN
ELIZABETH PA
15037-1081
US

V. Phone/Fax

Practice location:
  • Phone: 412-675-8516
  • Fax:
Mailing address:
  • Phone: 608-718-1484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: