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General NPI Number Information
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NPI Number | 1649670167
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Entity Type | Organization
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Legal Business Name | NEIL L. MOSER, LCSW,LLC
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Dates
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Enumeration Date | 09/03/2014
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Last Update Date | 09/03/2014
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Provider Practice Location Address
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Address Line | 16 WALNUT AVE SW 16 WALNUT AVENUE
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City | ROANOKE
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State | VA
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Zip | 24016-4719
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Country | US
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Telephone | 540-580-1807
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Fax |
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Provider Business Mailing Address
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Address Line | 16 WALNUT AVE SW 16 WALNUT AVENUE
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City | ROANOKE
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State | VA
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Zip | 24016-4719
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Country | US
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Telephone | 540-580-1807
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. NEIL L. MOSER
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Credential | LCSW
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Telephone | 540-580-1807
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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 | 0904006825
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License Number State | VA
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