MEDICARE: AMY JEAN MOSHER-GARVEY MSSW, LCSW, CSAC,ICS

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	6592	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831258060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY JEAN MOSHER-GARVEY MSSW, LCSW, CSAC,ICS

Provider Business Mailing Address
First Line	:	6502 GRAND TETON PLZ
Second Line	:	SUITE 102
City	:	MADISON
State	:	WI
Zip	:	53719-1047
Country	:	US
Telephone Number	:	608-827-7220
Fax Number	:	608-827-7223

Provider Business Practice Location Address
First Line	:	6502 GRAND TETON PLZ
Second Line	:	SUITE 102
City	:	MADISON
State	:	WI
Zip	:	53719-1047
Country	:	US
Telephone Number	:	608-827-7220
Fax Number	:	608-827-7223

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

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	08/27/2014

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