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General NPI Number Information
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NPI Number | 1508911579
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Entity Type | Individual
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Provider Name | JAMES MOSES LCSW
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Gender | Male
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 05/11/2020
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Provider Practice Location Address
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Address Line | 13575 58TH ST N STE 115
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City | CLEARWATER
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State | FL
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Zip | 33760-3755
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Country | US
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Telephone | 727-767-0508
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Fax |
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Provider Business Mailing Address
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Address Line | 1468 62ND AVE S
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City | ST PETERSBURG
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State | FL
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Zip | 33705-5623
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Country | US
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Telephone | 727-741-7345
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LC6032
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW11980
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License Number State | FL
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