MEDICARE: CYNTHIA RAE MOSES LSCSW

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	101YM0800X	Mental Health Counselor	1887	KS

General Provider Information

NPI Number	:	1669666566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA RAE MOSES LSCSW

Provider Business Mailing Address
First Line	:	155 S 18TH ST
Second Line	:	SUITE 222
City	:	KANSAS CITY
State	:	KS
Zip	:	66102-5642
Country	:	US
Telephone Number	:	913-766-4206
Fax Number	:	913-766-4210

Provider Business Practice Location Address
First Line	:	155 S 18TH ST
Second Line	:	SUITE 222
City	:	KANSAS CITY
State	:	KS
Zip	:	66102-5642
Country	:	US
Telephone Number	:	913-766-4206
Fax Number	:	913-766-4210

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

Provider Enumeration Date	:	09/04/2007
Last Update Date	:	09/04/2007

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