MEDICARE: MOSHER PSYCHOLOGICAL SERVICES, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1154855831
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOSHER PSYCHOLOGICAL SERVICES, PLLC

Provider Business Mailing Address
First Line	:	900 AMERICAN BLVD E STE 212
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55420-1393
Country	:	US
Telephone Number	:	612-238-8988
Fax Number	:	612-677-3099

Provider Business Practice Location Address
First Line	:	900 AMERICAN BLVD E STE 212
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55420-1393
Country	:	US
Telephone Number	:	612-238-8988
Fax Number	:	612-677-3099

Authorized Official
Title or Position	:	SOLE PROPRIETOR/PSYCHOLOGIST
Name	:	DR. JAMES MOSHER
Credential	:	PH.D.
Telephone Number	:	612-238-8988

Provider Enumeration Date	:	04/19/2017
Last Update Date	:	11/25/2025

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