MEDICARE: LAURA B MOSS LCSW

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	1041C0700X	Clinical Social Worker	44SC04530500	NJ

General Provider Information

NPI Number	:	1346507449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA B MOSS LCSW

Provider Business Mailing Address
First Line	:	9 CHERRY BROOK LN
Second Line	:
City	:	EAST WINDSOR
State	:	NJ
Zip	:	08520-1203
Country	:	US
Telephone Number	:	732-306-9198
Fax Number	:	609-371-1357

Provider Business Practice Location Address
First Line	:	9 CHERRY BROOK LN
Second Line	:
City	:	EAST WINDSOR
State	:	NJ
Zip	:	08520-1203
Country	:	US
Telephone Number	:	732-306-9198
Fax Number	:	609-371-1357

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2012
Last Update Date	:	06/28/2024

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