Healthcare Provider Details

I. General information

NPI: 1881922268
Provider Name (Legal Business Name): COURTNEY N MCCANN MOSLEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2009
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 ANNJO CT STE B
FOREST VA
24551-2630
US

IV. Provider business mailing address

12735 FOREST RD
FOREST VA
24551-3570
US

V. Phone/Fax

Practice location:
  • Phone: 207-615-7338
  • Fax:
Mailing address:
  • Phone: 207-615-7338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: