Healthcare Provider Details

I. General information

NPI: 1649546565
Provider Name (Legal Business Name): JULIE A MOSER LPCC, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2012
Last Update Date: 05/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 BROADWAY
EVERETT WA
98201-1700
US

IV. Provider business mailing address

PO BOX 2569
EVERETT WA
98213-0569
US

V. Phone/Fax

Practice location:
  • Phone: 425-493-5803
  • Fax: 425-493-5801
Mailing address:
  • Phone: 425-493-5803
  • Fax: 425-493-5801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLH60300769
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH 60300769
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE 0700028
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: