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General NPI Number Information
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NPI Number | 1508743154
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Entity Type | Individual
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Provider Name | LISA AUSTIN MOSES LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 429 GAMMON PL STE 200
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City | MADISON
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State | WI
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Zip | 53719-1053
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Country | US
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Telephone | 608-824-7243
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Fax |
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Provider Business Mailing Address
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Address Line | 7125 BIRCHSTONE DR
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City | MADISON
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State | WI
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Zip | 53719-5232
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Country | US
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Telephone | 608-712-0790
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10137-123
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License Number State | WI
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