Healthcare Provider Details

I. General information

NPI: 1992759799
Provider Name (Legal Business Name): MR. CHRISTIAN WENGER MOSEMANN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CHRISTIAN W MOSEMANN LCSW

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12420 WARWICK BLVD BUILDING 7, SUITE C
NEWPORT NEWS VA
23606-3001
US

IV. Provider business mailing address

239 YODER LN
NEWPORT NEWS VA
23602-6558
US

V. Phone/Fax

Practice location:
  • Phone: 757-595-3900
  • Fax: 757-595-0649
Mailing address:
  • Phone: 757-877-5930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904000119
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: